CERTIFICATION OF INABILITY TO PAY TRANSPORTATION COSTS

ICR 199202-2900-002

OMB: 2900-0257

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
147801 Migrated
ICR Details
2900-0257 199202-2900-002
Historical Active 198812-2900-002
VA
CERTIFICATION OF INABILITY TO PAY TRANSPORTATION COSTS
Revision of a currently approved collection   No
Regular
Approved without change 03/27/1992
Retrieve Notice of Action (NOA) 02/10/1992
  Inventory as of this Action Requested Previously Approved
03/31/1995 03/31/1995 03/31/1992
208,400 0 450,000
27,787 0 60,000
0 0 0

THIS FORM WILL BE USED BY VETERAN CLAIMANTS TO PROVIDE INCOME INFORMATION, WHICH WILL FORM THE BASIS FOR A DETERMINATION AS TO THE CLAIMANT'S ELIGIBILITY FOR REIMBURSEMENT OF TRAVEL COSTS INCURRED TO OBTAIN VA BENEFITS.

None
None


No

1
IC Title Form No. Form Name
CERTIFICATION OF INABILITY TO PAY TRANSPORTATION COSTS VA 2323

  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 208,400 450,000 0 0 -241,600 0
Annual Time Burden (Hours) 27,787 60,000 0 0 -32,213 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.
02/10/1992


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