Approved
consistent with VA memo submitted to OMB on 6/15/04. VA will report
a violation of 7465 hours associated with the previous approval for
this collection as a violation in the 2004 Information Collection
Budget.
Inventory as of this Action
Requested
Previously Approved
06/30/2007
06/30/2007
03/31/2005
1,900,000
0
5,985,000
1,005,000
0
2,655,417
0
0
0
Collects information to enroll for
health care benefits, establishes basic eligibility, identifies 3rd
party health insurance coverage and identifies prescription
copayment and serves as a mechanism to make changes upon admission
or yearly financial updates.
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.