Principles of Excellence Complaint System Intake

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
PoE-Complaint System-Screenshots-Intake (20131104).docx	Supplementary Document	Uploaded 2013-11-04	Available
PoE-IC Supporting Statement (Comment Incl)(Final).doc	Supporting Statement A	Uploaded 2013-12-12	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
208942	Principles of Excellence Complaint System Intake	Other-Screenshots	New

ICR Details

OMB Control No: 2900-0797	ICR Reference No: 201308-2900-030
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: VA	Agency Tracking No: 2900-NEW VBA-EDU-NK
Title: Principles of Excellence Complaint System Intake
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: Approved with change	Conclusion Date: 12/13/2013
	Date Received in OIRA: 10/28/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2016	36 Months From Approved
Responses	1,200	0	0
Time Burden (Hours)	300	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Executive Order 13607, Establishing Principles of Excellence for Educational Institutions Serving Service Members, Veterans, Spouses, and Other Family Members, requires the establishment of a centralized complaint system for VA, DOD, and Department of Education. The purpose of the complaint system is to provide a standardized method for beneficiaries and others to submit a complaint or allegation that an entity or individual has not or may not have adhered to the principles of excellence established in the Executive Order. The Complaint Intake System will enable VA to identify the entity or individual not in compliance with the Principles of Excellence and to assess the complaints of noncompliance. Assessment of compliance will include identifying areas we can improve to ensure adherence to the Principles of Excellence.

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Authorizing Statute(s): EO: EO 13607 Name/Subject of EO: Principles of Excellence
  

Citations for New Statutory Requirements: None

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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 167	08/28/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 207	10/25/2013
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
Principles of Excellence Complaint System Intake

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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	1,200	0	0	1,200	0	0
Annual Time Burden (Hours)	300	0	0	300	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 the initial annual burden for this collection of information.

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Annual Cost to Federal Government: $194,812

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: 10/28/2013

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