View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 9000-0011	ICR Reference No: 202310-2900-002CF
Status: Active	Previous ICR Reference No: 202102-2900-001CF
Agency/Subagency: VA	Agency Tracking No: PPS
Title: Preaward Survey Forms (Standard Forms 1403, 1404, 1405, 1406, 1407, and 1408)
Type of Information Collection: RCF Recertification	Common Form ICR:
Type of Review Request:
OIRA Conclusion Action: Approved	Conclusion Date: 10/17/2023
	Date Received in OIRA: 10/17/2023
Terms of Clearance: VA may use this common form in conformance with requirements set forth in 41 CFR Part 102-194 and in GSA's Standard and Optional Forms Procedural Handbook.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2026	36 Months From Approved	01/31/2024
Responses	6	0	6
Time Burden (Hours)	144	0	144
Cost Burden (Dollars)	9,648	0	8,208

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	6	6	0
Annual Time Burden (Hours)	144	144	0
Annual Cost Burden (Dollars)	9,648	8,208	1,440

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

Annual Cost to Federal Government: $7,344

Does this IC contain surveys, censuses, or employ statistical methods?

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? No

Agency Contact: Bogdan Vaga 202 382-2667 bogdan.vaga@va.gov

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