OMB2900-0565(21P-530a)(10-2-14)

Supporting Statement for VA Form 21P-530A

(Previously VA Form 21-530A)

State Application for Interment Allowance under 38 USC Chapter 23

(2900-0565)

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. 2302 and 2303. The form is being transferred from Compensation Service to Pension and Fiduciary Service due to change in the business line.

2. VA Form 21P-530A is used to gather information that is necessary to determine whether a State is eligible for interment allowances for eligible veterans who have been buried in a State Veteran's cemetery. Without this information, VA would be unable to properly determine eligibility and pay benefits. This form solicits information necessary to determine eligibility to burial benefits.

3. VA Form 21P-530A is available on the One-VA Website 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 form to be incorporated with an existing centralized legacy database.

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. Since the collection of information involves funeral businesses, specific instructions have been provided in reference to the statement of accounts required to accompany the claims.

6. The VA compensation and pension programs require current information to determine eligibility for benefits. Without the information provided on this form, it would not be possible to obtain the information needed to make a determination and reimburse a claimant.

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 October 2, 2014, Volume 79, No. 191, page 59560. No comments were received in response to this notice.

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 58VA21/22/28,‘‘Compensation, Pension, Education, and Rehabilitation Records—VA ’’as set forth in Privacy Act Issuances, 1993 compilation found in 74 Fed. Reg. 117 (June 19, 2009).

11. There are no questions of a sensitive nature.

12. Estimate of Information Collection Burden.

a. Number of Respondents: 3,100 per year.

b. Frequency of Response: one time

c. Annual burden hours: 1,550

d. Estimated Completion Time: 30 minutes is based on review by staff personnel and previous usage of this form.

e. According to the U.S. Bureau of Labor Statistics Average Hourly Earnings, the cost to the respondent is $24, making the total cost to the respondents an estimated $37,200. (1,550 burden hours x $24 per hour).

13. This submission does not involve any recordkeeping costs.

14. Estimated Costs to the Federal Government:

a. Processing/Analyzing costs $88,102

(GS-11/5 @ $33.92 x 3,100 x 30/60 minutes = $52,576)

(GS–7/5 @ $22.92 x 3,100 x 30/60 minutes = $35,526)

b. Printing and production cost $420

c. Total cost to government $88,522

15. The expiration date is being added to the form.

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

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

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

B. Collection of Information Employing Statistical Methods

This collection of information does not employ statistical methods.