Application and reporting Requirements to Receive Grants Under 38 CFR 17.703, RIN 2900-AO01

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form VA Form 10-10056 Application and reporting Requirements to Receive Grants Under 38 CFR 17.703, RIN 2900-AO01	Form and Instruction	New	Available
4040-0006.pdf	Supplementary Document	Uploaded 2012-10-02	Available
4040-0002.pdf	Supplementary Document	Uploaded 2012-10-02	Available
VTS Survey_VA Form 10-0517.docx	Supplementary Document	Uploaded 2012-10-02	Available
AO01_SF-425.pdf	Supplementary Document	Uploaded 2012-10-02	Available
AO01_SF-424.doc	Supplementary Document	Uploaded 2012-10-02	Available
PRA Justification_RIN_AO01-P_OIRA EDIT 3-5-13[1].docx	Supporting Statement A	Uploaded 2013-03-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
205997	Application and reporting Requirements to Receive Grants Under 38 CFR 17.703, RIN 2900-AO01	Form and Instruction	New

ICR Details

OMB Control No: 2900-0790	ICR Reference No: 201209-2900-005
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: VA	Agency Tracking No:
Title: Application and reporting Requirements to Receive Grants Under 38 CFR 17.703, RIN 2900-AO01
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Preapproved	Conclusion Date: 03/22/2013
	Date Received in OIRA: 11/14/2012
Terms of Clearance: The agency will ensure that the ICR displays the OMB control number and the required statement that persons are not required to respond to the collection of information unless it displays a currently valid OMB control number (5 CFR 1320.5(b)(2)(i)). This approval relates to an upcoming final rule and assumes no further changes when the final rule is published. If there are changes, it will have to be resubmitted.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2016	36 Months From Approved
Responses	1,267	0	0
Time Burden (Hours)	2,517	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Section 307 of title III of the Caregivers and Veterans Omnibus Health Services Act of 2010 (section 307) requires VA to establish a new program to provide grants to eligible entities to assist veterans in highly rural areas through innovative transportation services to travel to VA medical centers, and to otherwise assist in providing transportation services in connection with the provision of VA medical care to these veterans. Paragraph (a) of section 307 mandates that VA will award grants to eligible entities for these purposes, and paragraph (b) of section 307 mandates that VA will establish procedures for evaluating grant applications. This collection of information is necessary to fulfill VA's obligations under section 307.

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Authorizing Statute(s): PL: Pub.L. 111 - 163 307 Name of Law: Caregivers and Veterans Omnibus Health Services Act of 2010
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
2900-AO01	Proposed rulemaking	76 FR 251	12/30/2011

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 251	12/30/2011
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

IC Title	Form No.	Form Name
Application and reporting Requirements to Receive Grants Under 38 CFR 17.703, RIN 2900-AO01	VA Form 10-10055, VA Form 10-10056	Quarterly/Annual Grantee Performance Report ,   Grants for Transportation of Veterans in Highly Rural Areas

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	1,267	0	0	1,267	0	0
Annual Time Burden (Hours)	2,517	0	0	2,517	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 data collection and all hours are considered an increase.

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Annual Cost to Federal Government: $3,000,000

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

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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: 11/14/2012

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