Application for Accreditation as a Claims Agent or Attorney

Forms and Documents

Document Name	Status
Form 21A Application for Accreditation as a Claims Agent or Attorney Form	Modified
2900-0605 Justification RIN2900-AM62.DOC Supporting Statement A	2007-05-15

IC Document Collections

IC ID	Document Title	Status
28847	Application for Accreditation as a Claims Agent or Attorney Form	Modified

ICR Details

OMB Control No: 2900-0605	ICR Reference No: 200704-2900-007
Status: Historical Inactive	Previous ICR Reference No: 200503-2900-014
Agency/Subagency: VA	Agency Tracking No: 2900-0605
Title: Application for Accreditation as a Claims Agent or Attorney
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 08/22/2007
	Date Received in OIRA: 05/30/2007
Terms of Clearance: Withdrawn per VA request.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2008	36 Months From Approved	06/30/2008
Responses	20	0	20
Time Burden (Hours)	15	0	15
Cost Burden (Dollars)	0	0	0

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Abstract: Applicants seeking accreditation by VA as claims agents use this form to submit information needed by VA to make initial eligibility determinations.

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Authorizing Statute(s): US Code: 38 USC 5901 Name of Law: Prohibition against acting as claims agent or attorney
   US Code: 38 USC 5902 Name of Law: Recognition of representatives of organizations
   US Code: 38 USC 5903 Name of Law: Recognitin with respect to particular claims
   US Code: 38 USC 5904 Name of Law: Recognition of agents and attorneys generally
  

Citations for New Statutory Requirements: PL: Pub.L. 109 - 461 101(i) Name of Law: Limitation on collection of fee assessment

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
2900-AM62	Proposed rulemaking	72 FR 87	05/07/2007

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Application for Accreditation as a Claims Agent or Attorney	21A	Application for Accreditation as a Claims Agent or Attorney

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Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The adjustment is a result of a program requirement reflecting expanded accreditation requirements for agents and attorneys mandated by Congress in Public Law No. 109-461.

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Annual Cost to Federal Government: $14,909

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 05/30/2007

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