Application for Standard Government Headstone or Marker for Installation in Private or State Veterans Cemetery

Forms and Documents

Document Name	Status
Form VA 40-1330M Claim for Standard Government Headstone or Marker for Installation in Private or State Veterans Cemetery Form and Instruction	Modified
2900-0222 Justification July 2013 (corrected) OIRA 1-30-14 (CR2.6.14).doc Supporting Statement A	2014-02-07

IC Document Collections

IC ID	Document Title	Status
28470	Claim for Standard Government Headstone or Marker for Installation in Private or State Veterans Cemetery Form and Instruction	Modified

ICR Details

OMB Control No: 2900-0222	ICR Reference No: 201304-2900-020
Status: Historical Active	Previous ICR Reference No: 201112-2900-006
Agency/Subagency: VA	Agency Tracking No: 2900-0222
Title: Application for Standard Government Headstone or Marker for Installation in Private or State Veterans Cemetery
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/12/2014
	Date Received in OIRA: 11/08/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2017	36 Months From Approved	02/28/2014
Responses	354,573	0	374,000
Time Burden (Hours)	88,643	0	93,500
Cost Burden (Dollars)	0	0	0

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Abstract: Information is used to apply for a government provided headstone/marker for unmarked graves of eligible veterans and dependents.

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Authorizing Statute(s): US Code: 38 USC Section 2306 Name of Law: Headstones, markers, and burial receptacles
   PL: Pub.L. 110 - 157 201 Name of Law: . James Allen Veteran Vision Equity Act of 2007
   US Code: 38 USC Section 2411 Name of Law: The Dignified Burial and Other Veterans' Benefits Improvement Act of 2012
   PL: Pub.L. 107 - 103 501 and 502 Name of Law: Government Markers for Marked Graves at Private Cemeteries
  

Citations for New Statutory Requirements: PL: Pub.L. 110 - 157 201 Name of Law: Blinded Veterans Paired Organs Act of 2007

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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
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 110	06/07/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 207	10/25/2013
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
Claim for Standard Government Headstone or Marker for Installation in Private or State Veterans Cemetery	VA 40-1330M, VA40-1330	Claim For Government Medallion For Placement in a Private Cemetery ,   Claim For Standard Government Headstone or Marker

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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	354,573	374,000	0	-19,427	0	0
Annual Time Burden (Hours)	88,643	93,500	0	-4,857	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: It appears that less government-furnished headstones and markers were provided last fiscal year. The number of government-furnished headstones and markers requested yearly varies from year to year. The VA does not have a way of predicting exactly how many veterans' families will apply for this benefit. The Dignified Burial and Other Veterans' Benefits Improvement Act of 2012, enacted on January 10, 2013 amends Title 38 U.S.C. section 2411, to prohibit VA from providing interment or memorialization benefits to Tier III sex-offenders who were sentenced to a minimum of life imprisonment and whose conviction is final. Title 38 U.S.C Section 2411 also prohibits VA from providing interment or memorialization benefits to individuals who committed a State of Federal Capital Crime. As a result of this law, we are now required to ask the applicant to certify that "to the best of your knowledge, that the decedent has never committed a serious crime, such as murder or other offense that could have resulted in imprisonment for life, has never been convicted of a serious crime, and has never been convicted of a sexual offense for which he or she was sentenced to a minimum of life imprisonment. This is considered a question of sensitive nature.

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Annual Cost to Federal Government: $403,300

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: 11/08/2013

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