This request is
approved with the condition that items 4b and 4c are removed.
Please send a copy of the printed form to OMB for our files.
Inventory as of this Action
Requested
Previously Approved
06/30/1984
06/30/1984
05/31/1981
2,400
0
2,400
800
0
800
0
0
0
THIS FORM IS USED TO OBTAIN SUPPORTING
STATEMENTS ATTESTING TO THE FACT THAT THE VETERAN AND THE VETERAN'S
SPOUSE HAD ESTABLISHED A MARITAL RELATIONSHIP THAT IS RECOGNIZED BY
THE COMMUNITY. IN ADJUDICATING THE CLAIM IT MUST BE ESTABLISHED
FROM STATEMENTS OF OTHER PERSONS THAT THE PARTIES DID LIVE TOGETHER
AND HOLD THEMSELVES OUT BEFORE THE COMMUNITY AS HUSBAND AND
WIFE.
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.