Authorization and Certification of Entrance or Reentrance into Rehabilitation and Certification of Status (28-1905)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 28-1905 Authorization and Certification of Entrance or Reentrance into Rehabilitation and Certification of Status	Form	Modified	Available
OMB.2900_0014.Comment	Public Comments	Uploaded 2014-12-23	Repair queued
30-Day FRN (2900-0014)(12-16-14).pdf	Supplementary Document	Uploaded 2014-12-23	Available
60-Day FRN (2900-0014)(10-2-14).pdf	Supplementary Document	Uploaded 2014-10-20	Available
OMB2900-0014(28-1905)(12-29-14).docx	Supporting Statement A	Uploaded 2015-01-07	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
28099	Authorization and Certification of Entrance or Reentrance into Rehabilitation and Certification of Status (28-1905)	Form	Modified	Authorization and Certification of Entrance or Reentrance into Rehabilitation and Certification of Status

ICR Details

OMB Control No: 2900-0014	ICR Reference No: 201403-2900-017
Status: Historical Active	Previous ICR Reference No: 201106-2900-007
Agency/Subagency: VA	Agency Tracking No: 2900-0014 VBA-VR&E-DB
Title: Authorization and Certification of Entrance or Reentrance into Rehabilitation and Certification of Status (28-1905)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/20/2015
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/21/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2018	36 Months From Approved	03/31/2015
Responses	90,000	0	90,000
Time Burden (Hours)	7,500	0	7,500
Cost Burden (Dollars)	0	0	0

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Abstract: The VA case manager completes sections A and B and send the form to the veteran's or other eligible person's training facility or service provider. The facility or service provider then completes section C to verify to VA that the individual has entered the planned program. The facility uses a copy for voucher purposes.

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Authorizing Statute(s): US Code: 38 USC 501(a) Name of Law: Rules and regulations
   US Code: 38 USC 3108 Name of Law: Allowances
   US Code: 38 USC 3680(g) Name of Law: Payment of educational assistance or subsistence
  

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:
	79 FR 191	10/02/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 241	12/16/2014
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
Authorization and Certification of Entrance or Reentrance into Rehabilitation and Certification of Status (28-1905)	28-1905	Authorization and Certification of Entrance or Reentrance into Rehabilitation and Certification of Status

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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	90,000	90,000	0	0	0	0
Annual Time Burden (Hours)	7,500	7,500	0	0	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: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $291,675

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: 01/21/2015

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