Approved
consistent with the following terms of clearance: in the next
submission of this collection of information to OMB, VA shall
report on the status of agency efforts to allow complete electronic
submission of associated forms.
Inventory as of this Action
Requested
Previously Approved
08/31/2008
08/31/2008
08/31/2005
1,000
0
1,000
250
0
250
0
0
0
VA Form 21-4169 is used to gather
information that is necessary to determine eligibility for benefits
based on service in the Commonwealth Army of the Philippines or
recognized guerrilla organizations, including service information,
proof of service, place of residence, and membership in
pro-Japenese, pro-German, or anti-American Filipino organizations.
Without this information, VA would be unable to properly authorize
benefits.
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.