Statement in Support of Claim Filipino Veterans Equity Compensation Fund)

Forms and Documents

Document Name	Status
Form VA Form 21-4138(CF Statement in Support of Claim (Filipino Veterans Equity Compensation Fund) Form	New
21-4138(CF) supplementary.doc Supporting Statement B	2009-03-17
21-4138(CF)[2].doc Supporting Statement A	2009-03-17

IC Document Collections

IC ID	Document Title	Status
188137	Statement in Support of Claim (Filipino Veterans Equity Compensation Fund) Form	New

ICR Details

OMB Control No: 2900-0724	ICR Reference No: 200902-2900-013
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: VA	Agency Tracking No:
Title: Statement in Support of Claim Filipino Veterans Equity Compensation Fund)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 03/13/2009
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/18/2009
	Date Received in OIRA: 03/03/2009
Terms of Clearance: This collection is approved with the following terms of clearance: this collection is approved as an emergency clearance to meet American Reinvestment Recovery Act requirements. This collection will be valid for six months. If VA decides to continue use of the collection past the approved emergency request clearance time period, it must resubmit to OMB under the normal PRA clearance process for a three-year approval.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2009	6 Months From Approved
Responses	18,000	0	0
Time Burden (Hours)	1,500	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: VA Form 21-4138(CF) is used to gather information to establish the provision of a one-time payment to an honorably discharged veteran who served, before July 1, 1946 in the organized military forces of the Government of the Commonwealth of the Philippines, including certain service in the Philippine Scouts or in organized guerrilla forces recognized by the United States Army, while such forces were in the service of the Armed Forces of the United States.

Emergency Justfication: VA is requesting an emergency approval for VA Form 21-4138(CF), Statement in Support of Claim, for Filipino Veterans Equity Compensation Fund (FVEC). VA Form 21-4138 is being overprinted to collect information from honorably discharged Filipino veterans' of WWII who served in the Armed Forces of the United States and who may be eligible to receive a one-time payment from FVEC, which is a part of the President's Stimulus Package. The information on VA Form 21-4138(CF)is needed to determine the veteran’s eligibility for payments. Applicants seeking this one-time payment must file their claim on or before February 16, 2010, therefore, VA is requesting approval to use VA Form 21-4138(CF)for one year.

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Authorizing Statute(s): US Code: 38 USC 501 Name of Law: Sec. 501. Rules and regulations
   PL: Pub.L. 111 - 5 1002 Name of Law: American Recovery and Reinvestment
  

Citations for New Statutory Requirements: Statute at Large: 120 Stat. 2094 Name of Statute: American Recovery and Reinvestment

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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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
Statement in Support of Claim (Filipino Veterans Equity Compensation Fund)	VA Form 21-4138(CF)	Statement in Support of Claim (Filipino Veterans Equity Compensation Fund)

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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	18,000	0	18,000	0	0	0
Annual Time Burden (Hours)	1,500	0	1,500	0	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: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new collection of information.

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Annual Cost to Federal Government: $668,442

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)? Yes

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: 03/03/2009

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