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 .DOC Supporting Statement A	2007-12-13

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: 200712-2900-011
Status: Historical Active	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: Approved without change	Conclusion Date: 05/14/2008
	Date Received in OIRA: 12/13/2007
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2011	36 Months From Approved	06/30/2008
Responses	137	0	20
Time Burden (Hours)	103	0	15
Cost Burden (Dollars)	0	0	0

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Abstract: Individuals seeking accreditation by VA as claims agents or attorney 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 cliams agent or attorney
   US Code: 38 USC 5902 Name of Law: Recognition of representatives of organizations
   US Code: 38 USC 5903 Name of Law: Recognition 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	Final or interim final 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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ICR Summary of Burden

	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	137	20	0	117	0	0
Annual Time Burden (Hours)	103	15	0	88	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

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: 12/13/2007

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