REQUEST FOR CONFIDENTIAL VERIFICATION OF BIRTH

ICR 198904-2900-053

OMB: 2900-0142

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
174361 Migrated
ICR Details
2900-0142 198904-2900-053
Historical Active 198904-2900-042
VA
REQUEST FOR CONFIDENTIAL VERIFICATION OF BIRTH
No material or nonsubstantive change to a currently approved collection   No
Emergency 04/18/1989
Approved with change 04/18/1989
Retrieve Notice of Action (NOA) 04/18/1989
  Inventory as of this Action Requested Previously Approved
01/31/1992 01/31/1992 01/31/1992
1,575 0 1,575
788 0 788
0 0 0

38 CFR 3.209 REQUIRES A COPY OF THE PUBLIC RECORD OF BIRTH BE SUBMITTED FOR PROOF OF AGE OR RELATIONSH IF AVAILABLE. THE FORM IS USED WHEN CIRCUMSTANCES INDICATE THAT ADJUDICATION WILL BE EXPEDITED AND THE EVIDENCE CAN BE OBTAINED WITHOU INCREASED COSTS.

None
None


No

1
IC Title Form No. Form Name
REQUEST FOR CONFIDENTIAL VERIFICATION OF BIRTH 21-4504

  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 1,575 1,575 0 0 0 0
Annual Time Burden (Hours) 788 788 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
04/18/1989


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