Supporting Statement for VAF 21-601 05-17-13

Supporting Statement for VA Form 21-601

Application for Accrued Amounts Due a Deceased Beneficiary

(2900-0216)

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 38 U.S.C. 5121 which provides the eligibility criteria for the payment of accrued benefits. Regulatory authority is found in 38 CFR 3.1000 and 38 CFR 3.1001.

2. VA Form 21-601 is used to gather information that is necessary to determine entitlement to accrued benefits. Accrued benefits are amounts of VA benefits due and unpaid to a deceased beneficiary at the time of death. Benefits are paid to survivors based on the order of preference shown in 38 U.S.C. 5121; however, when there are no survivors who are entitled based on relationship, the person or persons who bore the expenses of the beneficiary’s last illness and burial may claim reimbursement for these expenses from accrued amounts.

3. VA Form 21-601 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 currently 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 forms to be incorporated with an existing centralized legacy database. Veterans Online Applications (VONAPP) allows applicants to view, print, and submit applications electronically to VBA. However, VA Form 21-601 is not one of the forms scheduled to be added to VONAPP because estimated total usage of this form is minimal. The Department will reconsider adding this form to VONAPP when the resources become available or if usage of this form becomes greater.

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 may involve funeral businesses and other unpaid creditors. Specific instructions have been provided regarding the statements of account required to accompany the claim.

6. This form solicits information that is necessary to determine the proper payee for accrued benefits and the amount payable. Without the information provided on this form, it would not be possible to obtain the information needed to authorize benefits.

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 June 6, 2013, page 34174. Field stations have not reported any difficulty on the part of respondents in using the form. No comments were received.

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 “Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28),” published at 74 FR 29275 on June 19, 2009, and last amended at 77 FR 42593 (July 19, 2012).

11. There are no questions of a sensitive nature.

12. Estimate of Information Collection Burden.

a. Number of Respondents is estimated at 4,600 per year.

b. Frequency of Response is one time for most beneficiaries.

c. Annual burden is 2,300 hours.

d. The estimated completion time of 30 minutes is based on review by staff personnel and previous usage of this form.

e. The total estimated cost to respondents is $34,500 (2,300 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 $173,580

(GS-12/5 @ $48.35 x 4,600 x 15/60 = $55,603)

(GS-9/5 @ $28.04 x 4,600 x 47/60 = $101,037)

(GS-3/5 @ $14.73 x 4,600 x 15/60 = $16,940)

b. Printing and production cost $420

c. Total cost to government $174,000

15. There is no change in the respondent burden.

16. The information collection is not for publication or tabulation use.

17. The collection instrument, VA Form 21-601, may be reproduced and/or stocked by the respondents and veterans service organizations. This VA form does not display an expiration date, and if required to do so would result in unnecessary waste of existing stocks of this form. This form is submitted to OMB every 3 years. As such, this date requirement would also result in an unnecessary burden on the respondents and would delay Department action on the benefit being sought. VA also seeks to minimize its cost to itself of collecting, processing and using the information by not displaying the expiration date. For the reasons stated, VA continues to seek an exemption that waives the displaying of the expiration date on VA Form 21-601.

18. This submission does not contain any exceptions to the certification statement.

B. Collection of Information Employing Statistical Methods

1. The Veterans Benefits Administration does not collect information employing statistical methods.