2900-0212 Ss 1.14.14

2900-0212 SS 1.14.14.doc

Veterans Mortgage Life Insurance Statement

OMB: 2900-0212

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SUPPORTING STATEMENT

VA FORM 29-8636

VETERANS MORTGAGE LIFE INSURANCE STATEMENT

2900-0212


Part A.

  1. This form is used by veterans who have received Specially Adapted Housing Grants to decline Veterans Mortgage Life Insurance (VMLI) or to provide information upon which the insurance premium can be based. The information requested is authorized by law, 38 USC Section 2106.


2. The information collected on this form is used by the Department of Veterans Affairs (VA) to process the insured’s request.


3. VA Form 29-8636 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 this 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.


4. The information is not contained in any other VA records. Similar information is not available elsewhere.


5. The information does not involve any small businesses.


6. This form is designed for use by the insured to establish his/her eligibility for the insurance or to decline it.


7. There are no special circumstances requiring that the collection of information be conducted in a manner inconsistent with the guidelines in 5 CFR Section 1320.6.


8. The Department notice was published in the Federal Register on September 24, 2013, Volume 78, Number 185, Page 58611. There are no persons outside the VA with whom the material submitted was discussed. There were no public contacts. The information does not involve obtaining information from any state or local Government. There is no person or organization other than VA that will collect the information which is submitted by the insured.


9. The information collected is supplied by the respondent. No remuneration is made.


10. The information collection conforms with the Privacy Act of 1974 and is subject to the conditions of disclosure contained therein. The records are maintained in the system identified as 36VA00, “Veterans and Armed Forces Personnel United States Government Life Insurance Records - VA” as contained in the Privacy Act Issuances, 1993 Compilation.


11. There are no questions of a sensitive nature.



12. We estimate that approximately 1000 forms a year will be received. We also estimate that it will take approximately 15 minutes to complete this form. We arrived at this estimate by initiating a trial with a VA staff member unfamiliar with the form. The annual burden will now be 250 hours.


13. This submission does not involve any record keeping costs.


14. Cost to Government:


$899.00 Estimated mailing cost (1,000 X 2 minutes per

form X $15.51/hour (average salary for station

mail personnel) plus 1,000 X 38.2 cents each

(presort discount)).


$466.00 Estimated cost for collections (1000 X 2 minutes

per X $13.98/hour (average salary of station collections

personnel)).


$9,915.00 Estimated cost for processing (1000 forms X 30

minutes per form X $19.83/hour (average salary

for reviewers).


$45.00 Estimated printing costs (1,000 X $45/1,000 forms).


$11,325.00 Total cost to the Government.


$3,750.00 Cost to reporting public (250 hours X $15/hour).


15. There is a change in respondent burden due to an adjustment.


16. The information is collected for insurance purposes only and there are no plans for publication.


17. We are not seeking approval to omit the expiration date for OMB approval.


18. There are no exceptions to the certification statement identified in Item 19 of

OMB Form 83-I.


Part B. Collection of Information Employing Statistical Methods


This collection does not employ statistical methods.


File Typeapplication/msword
File TitleSUPPORTING STATEMENT
AuthorVeterans Benefits Administrat
Last Modified ByRennie, Crystal
File Modified2014-01-14
File Created2014-01-14

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