NOTICE TO VA OF VETERAN OR BENEFICIARY INCARCERATED IN PENAL INSTITUTION

ICR 198012-2900-010

OMB: 2900-0116

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
2900-0116 198012-2900-010
Historical Active 198011-2900-082
VA
NOTICE TO VA OF VETERAN OR BENEFICIARY INCARCERATED IN PENAL INSTITUTION
Revision of a currently approved collection   No
Regular
Approved without change 02/13/1981
Retrieve Notice of Action (NOA) 12/22/1980
  Inventory as of this Action Requested Previously Approved
09/30/1983 09/30/1983 10/31/1982
5,000 0 2,400
416 0 200
0 0 0

THIS FORM IS USED TO OBTAIN INFORMATION REGARDING THE INCARCERATION OF ANY INDIVIDUAL IN RECEIPT OF OR FOR WHOM BENEFITS ARE PAID. WHEN SUCH AN INDIVIDUAL IS INCARCERATED, BENEFITS MUST BE DISCONTINUED UNTIL RELEASE FROM INCARCERATION. AUTHORITY IS 38 U.S.C. 505.

None
None


No

1
IC Title Form No. Form Name
NOTICE TO VA OF VETERAN OR BENEFICIARY INCARCERATED IN PENAL INSTITUTION VA21-4193

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 5,000 2,400 0 2,600 0 0
Annual Time Burden (Hours) 416 200 0 216 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/22/1980


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