VA National Rehabilitation Special Events

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0924a VA National Rehabilitation Special Events	Form	New	Available
Special Event Forms justification2.doc	Supporting Statement A	Uploaded 2010-06-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
193170	VA National Rehabilitation Special Events	Form	New

ICR Details

OMB Control No: 2900-0759	ICR Reference No: 201006-2900-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: VA	Agency Tracking No:
Title: VA National Rehabilitation Special Events
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/08/2010
	Date Received in OIRA: 06/10/2010
Terms of Clearance: VA is reminded that the Department must seek and obtain an OMB control number per the Paperwork Reduction Act prior to collecting information governed by the statute. VA should consider providing an electronic option to respondents for providing information and in the next submission of this collection the Department shall report to OMB on the feasibility of an electronic option.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2013	36 Months From Approved
Responses	3,775	0	0
Time Burden (Hours)	1,257	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: VA administers National Rehabilitation Special Events for veterans who are receiving care at VA medical facilities. These events are: The National Disabled Veterans Winter Sports Clinic, National Veterans Wheelchair Games, National Veterans Golden Age Games, National Veterans Creative Arts Festival, National Veterans Summer Sports Clinic and National Veterans TEE Tournament. Each event promotes the healing of body and spirit by motivating eligible veterans to reach their full potential, improve their independence, achieve a healthier lifestyle and enjoy a higher quality of life. Veterans eligible for VA medical care may apply to attend these events using event applications.

---

Authorizing Statute(s): US Code: 38 USC Section 521 Name of Law: Assistance to certain rehabilitation activities
   US Code: 38 USC Section 1710 Name of Law: Eligibility for hospital, nursing home, and domiciliary care
   US Code: 38 USC Secti on 513 Name of Law: Contracts and personal services
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 39	03/01/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 88	05/07/2010
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
VA National Rehabilitation Special Events	0926f, 0928c, 0929a, 0929c, 0929e, 0929f, 0928d, 0928h, 0929g, 0926b, 0929b, 0925b, 0928i, 0924n, 0926j, 0926i, 0924b, 0924e, 0925d, 0929h, 0928a, 0928b, 0924t, 0925a, 0926g, 0924a, 0927a, 0927c, 0927e, 0924s, 0927b, 0926h, 0926c, 0928j, 0926a, 0926d, 0926e, 0927f, 0924c, 0927d, 0924d, 0925c	National Disabled Veterans Winter Sports Clinic, Registration Check List ,   Registration Application, National Disabled Veterans Winter Sport Clinic ,   General Ski Information, National Disabled Veterans Winter Sport Clinic ,   General Medical/Physical Exam Form, National Disabled Veterans Winter Sport Clinic ,   Media and News Release Questionnaire, National Disabled Veterans Winter Sport Clinic ,   Cross Country Ski Instructor Personnel Application, National Disabled Veterans Winter Sport Clinic ,   Downhill Ski Instruction Personnel Application, National Disabled Veterans Winter Sport Clinic ,   Volunteer Application, National Disabled Veterans Winter Sports Clinic ,   National Veterans Wheelchair Games Application ,   General Medical Form ,   Media and News Release Questionnaire, National Veterans Wheelchair Games ,   Voluntary Service Application, National Veterans Wheelchair Games ,   National Veterans Golden Age Games, Registration Check List ,   Athlete Application, National Veterans Golden Age Games ,   Media and New Release Questionnaire, National Veterans Golden Age Games ,   Surfing Personnel Application, National Veterans Summer Sports Clinic ,   Athlete Medical Information ,   Non-Competitor Application, National Veterans Golden Age Games ,   Volunteer Application, National Veterans Golden Age Games ,   Participant Registration Application, National Veterans Tee Tournament ,   Participant Registration Form-Physical Exam, National Veterans Tee Tournament ,   Media and News Release Questionnaire, National Veterans Tee Tournament ,   Registration Application, National Veterans Summer Sports Clinic ,   General Medical/Physical Exam Form, National Veterans Summer Sports Clinic ,   Media and News Release Questionnaire, National Veterans Summer Sports Clinic ,   Volunteer Application, National Veterans Summer Sports Clinic ,   Venue Personnel Application, National Veterans Summer Sports Clinic ,   National Veterans Creative Arts Festival, Participant Registration Check List ,   Participant Registration Application, National Veterans Creative Arts Festival ,   Participant Medical Information, National Veterans Creative Arts Festival ,   Family and Friends Lodging and Meals, National Veterans Creative Arts Festival ,   Media and News Release Questionnair, National Veterans Creative Arts Festival ,   Participant, Companion and Volunteer Fees, National Veterans Tee Tournament ,   Volunteer Registration Application, National Veterans Tee Tournament ,   National Veterans Summer Sports Clinic, Registration Check List ,   Non Competitor Meals ,   National Veterans Tee Tournament, Registration Check List ,   National Veterans Golden Age Games, Non-Competitor Registration Check List ,   Waivers and Release of Liability and Other Use Release, National Veterans Golden Age Games ,   Participant Agreement, National Veterans Creative Arts Festival ,   Ticket Request Form for Visual and Performing Arts Participants, National Veterans Creative Arts Festival Art and Exhibit & Stage Show ,   Alternate Activities

---

ICR Summary of Burden

table that charts list 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	3,775	0	0	3,775	0	0
Annual Time Burden (Hours)	1,257	0	0	1,257	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: New data collection.

---

Annual Cost to Federal Government: $42,582

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

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: 06/10/2010

---