8Supporting Statement for VA Form 21-4138(CF)
Statement in Support of Claim
(Filipino Veterans Equity Compensation Fund)
2900-0724
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 Public Law 111-5 Section 1002, 38 U.S.C. 501 and 38 C.F.R. 3.150.
2. VA Form 21-4138(CF ) is used 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. The form will be available for public use until February 16, 2010.
3. VA Form 21-4138(CF) is available on the One-VA web site in a fillable electronic format. VBA is currently hosting this form on a secure server and does not have the technology in place to allow for the complete submission of the form. Validation edits are performed to assure data integrity. Efforts within VA are underway to provide a mechanism to allow the information to be submitted electronically with a recognized signature technology. There currently is no utility process in place that will allow the data submitted on the form to be incorporated with an existing centralized legacy database. The Department will not add VA Form 21-4138 (CF) to Veterans Online Applications (VONAPP), due to the brief one year time period.
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. The collection of information does not involve small businesses or entities.
6. The VA compensation and pension programs require that statements submitted by or on behalf of a claimant contain certification by the respondent that the information provided is true and correct. This form is designed to facilitate claims processing by providing a uniform format for the certification statement.
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 April 15, 2009, (Volume 74, Number 71, page 17554). There were no comments received in response to this notice.
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, "Compensation, Pension, Education and Rehabilitation Records - VA" as set forth in Privacy Act Issuances, 1993 compilation found in 42 Fed. Reg. 49726 (9/27//1977).
11. There are no questions of a sensitive nature.
12. Estimate of Information Collection Burden.
a. Number of Respondents is estimated at 18,000 per year.
b. Frequency of Response is on occasion for most beneficiaries.
c. Annual burden is 1,500 hours.
d. The estimated completion time of 5 minutes is based on review by staff personnel and previous usage of this form.
e. The total estimated cost to respondents is $16,500 (1,100 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 $645,882
(GS-12/5 @ $39.70 x 18,000 x 15/60 minutes = $ 178,650)
(GS-9/5 @ $27.37 x 18,000 x 47/60 minutes = $385,917)
(GS-5/5 @ $18.07 x 18,000 x 15/60 minutes = $ 81,315)
b. Printing and production cost $22,560
c. Total cost to government $668,442
There is no change in the reporting burden.
16. The information collection is not for publication or tabulation use. The reporting requirements in PL 111-5 do not apply to payments made by VA to individuals under Section 1002.
17. The collection instrument, VA Form 21-4138(CF), may be reproduced and/or stocked by the respondents and veterans service organizations. VA is seeking a waiver not to display an expiration date on the form since the form will only be in use for one year.
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 methods.
| File Type | application/msword |
| File Title | SF 83 SS VAF 21-8926 |
| Author | Veterans Benefits Administrat |
| File Modified | 2009-07-01 |
| File Created | 2009-05-14 |