OMB21-530(4-22-09)

Supporting Statement for VA Form 21-530

Application for Burial Benefits

(2900-0003)

A. Justification

1. The Department of Veterans Affairs (VA), through its Veterans Benefits Administration (VBA), administers an integrated program of benefits and services established by law for veterans, service personnel, and their dependents and/or beneficiaries. Information is requested by this form under the authority of 38 U.S.C. 2302 and 2303.

2. VA Form 21-530 is used to gather the necessary information from a veteran’s relative or estate to determine if the veteran had appropriate service and/or disability, and the claimant has made appropriate payment for burial or has contracted to made appropriate payment. This form solicits information necessary to determine eligibility to burial benefits.

3. VA Form 21-530 is available on the VBA website for downloading by claimants. Claimants may print and submit applications non-electronically. VA Form 21-530 is also available in Veterans Online Applications (VONAPP). VONAPP allows applicants to view, print, and submit applications electronically to VBA.

4. Program reviews were conducted to identify potential areas of duplication; however, none were found to exist. There is no known Department or Agency which maintains the necessary information, nor is it available from other sources within our Department.

5. Since the collection of information involves funeral businesses, specific instructions have been provided in reference to the statement of accounts required to accompany the claims.

6. The VA compensation and pension programs require current information to determine eligibility for benefits. Without the information provided on this form, it would not be possible to obtain the information needed to make a determination and reimburse a claimant.

7. There is no special circumstance requiring collection in a manner inconsistent with 5 CFR 1320.6 guidelines.

8. The Department notice was published in the Federal Register on December 5, 2008, Volume 73, Number 235, pages 74231-74232. One comment was received. It was a suggestion that we pre-authorize burial claims for our beneficiaries. We were not able to implement the suggestion due to a lack of technology and certain factors that could affect a veterans eligibility.

9. No payments or gifts to respondents have been made under this collection of information.

10. The records are maintained in the appropriate Privacy Act System of Records identified as 58VA21/22/28, "Compensation, Pension, Education and Vocational Rehabilitation Records - VA" as set forth in Privacy Act Issuances, 1993 compilation.

11. There are no questions of a sensitive nature.

12. Estimate of Information Collection Burden.

a. Number of Respondents is estimated at 300,000 per year.

b. Frequency of Response is on occasion for most beneficiaries.

c. Annual burden is 110,000 hours.

d. The estimated completion time of 22 minutes is based on review by staff personnel and previous usage of this form.

e. The total estimated cost to respondents is $1,650,000 (110,000 hours x $15 per hour).

13. This submission does not involve any recordkeeping costs.

14. Estimated Costs to the Federal Government:

a. Processing/Analyzing costs $8,670,150

(GS-12/5 @ $37.89 x 300,000 x 2/60 minutes = $ 378,900)

(GS- 5/5 @ $23.12 x 300,000 x 45/60 minutes = $5,202,000)

(GS- 3/5 @ $13.73 x 300,000 x 45/60 minutes = $3,089,250)

b. Printing and production cost $7,500

c. Total cost to government $8,677,650

15. The increase in burden was due to additional information added to VA Form 21-530.

16. The information collection is not for publication or tabulation use.

17. The collection instrument, VA Form 21-530, may be reproduced and/or stocked by the respondents and veterans service organizations. This VA form does not display an expiration date, and if required to do so would result in unnecessary waste of existing stocks of this form. This form is submitted to OMB every 3 years. As such, this date requirement would also result in an unnecessary burden on the respondents and would delay Department action on the benefit being sought. VA also seeks to minimize its cost to itself of collecting, processing and using the information by not displaying the expiration date. For the reasons stated, VA continues to seek an exemption that waives the displaying of the expiration date on VA Form 21-530.

18. This submission does not contain any exceptions to the certification statement.

B. Collection of Information Employing Statistical Methods

The data collection does not employ statistical method