Application for Work Study Allowance; Student Work-Study Agreement (Advance Payment); Extended Student Work-Study Agreement; Student Work-Study Agreement (22-8691, 22-8692, 22-8692a, & 22-8692b)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 22-8692b STUDENT WORK-STUDY AGREEMENT	Form	Modified	Available
Form 22-8692a EXTENDED STUDENT WORK-STUDY AGREEMENT	Form	Modified	Available
Form 22-8691 APPLICATION FOR WORK-STUDY ALLOWANCE	Form	Modified	Available
Form 22-8692 STUDENT WORK-STUDY AGREEMENT (ADVANCE PAYMENT)	Form	Modified	Available
30-Day FRN - 2900-0209 (2015).pdf	Supplementary Document	Uploaded 2015-01-16	Available
60-Day FRN - 2900-0209 (2014).pdf	Supplementary Document	Uploaded 2014-12-23	Available
Supporting Statement for 2900-0209 (VA Forms 22-8691 and 8692 series) 1-16-15.docx	Supporting Statement A	Uploaded 2015-01-16	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
28453	Application for Work-Study Allowance, Student Work-Study Agreement (Advance Payment), Extended Student Work-Study Agreement, Student Work-Study Agreement	Form	Modified	STUDENT WORK-STUDY AGREEMENT
28453	Application for Work-Study Allowance, Student Work-Study Agreement (Advance Payment), Extended Student Work-Study Agreement, Student Work-Study Agreement	Form	Modified	EXTENDED STUDENT WORK-STUDY AGREEMENT
28453	Application for Work-Study Allowance, Student Work-Study Agreement (Advance Payment), Extended Student Work-Study Agreement, Student Work-Study Agreement	Form	Modified	APPLICATION FOR WORK-STUDY ALLOWANCE
28453	Application for Work-Study Allowance, Student Work-Study Agreement (Advance Payment), Extended Student Work-Study Agreement, Student Work-Study Agreement	Form	Modified	STUDENT WORK-STUDY AGREEMENT (ADVANCE PAYMENT)

ICR Details

OMB Control No: 2900-0209	ICR Reference No: 201409-2900-009
Status: Historical Active	Previous ICR Reference No: 201110-2900-015
Agency/Subagency: VA	Agency Tracking No: 2900-0209 VBA-EDU-YM
Title: Application for Work Study Allowance; Student Work-Study Agreement (Advance Payment); Extended Student Work-Study Agreement; Student Work-Study Agreement (22-8691, 22-8692, 22-8692a, & 22-8692b)
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: 02/12/2015
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	06/30/2015
Responses	38,635	0	33,700
Time Burden (Hours)	6,457	0	5,795
Cost Burden (Dollars)	0	0	0

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Abstract: Veterans, Reservists, and other beneficiaries submit these forms to VA to apply for a work-study allowance under 38 U.S.C. chapters 30, 31, 32, 33, and 35; Section 903 of Public Law 96-342; 10 U.S.C. chapters 1606 and 1607; and the National Call to Service provision of Public Law 107-314.

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Authorizing Statute(s): US Code: 10 USC 16166 Name of Law: chapter 1607 Administration
   US Code: 38 USC 3104 Name of Law: chapter 31 Scope of services and assistance
   US Code: 38 USC 3485 Name of Law: Work-Study Allowance
   PL: Pub.L. 110 - 252 5003 Name of Law: Post-9/11 Veterans Educational Assistance Act of 2008 (chapter 33)
   US Code: 10 USC 16136 Name of Law: chapter 1606 Administration
   PL: Pub.L. 96 - 342 903 Name of Law: Department of Defense Authorization Act, 1981
   PL: Pub.L. 107 - 314 531 Name of Law: Bob Stump National Defense Authorization Act for FY 2003
   US Code: 38 USC 3241 Name of Law: chapter 32 Administration
   US Code: 38 USC 3537 Name of Law: chapter 35 Administration
   US Code: 38 USC 3034(a) Name of Law: chapter 30 Administration
  

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 62712	10/20/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 1992	01/14/2015
Did the Agency receive public comments on this ICR? No

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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
Application for Work-Study Allowance, Student Work-Study Agreement (Advance Payment), Extended Student Work-Study Agreement, Student Work-Study Agreement	22-8691, 22-8692b, 22-8692, 22-8692a	STUDENT WORK-STUDY AGREEMENT (ADVANCE PAYMENT) ,   APPLICATION FOR WORK-STUDY ALLOWANCE ,   EXTENDED STUDENT WORK-STUDY AGREEMENT ,   STUDENT WORK-STUDY AGREEMENT

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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	38,635	33,700	0	4,935	0	0
Annual Time Burden (Hours)	6,457	5,795	0	662	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: The increase in the public burden hours to the current estimate of 6,457 hours (for 38,635 responses) reflects the increase in the annual projected number of applications, contracts, and extensions for FY 2014 through 2016 based on the actual number of these forms submitted for FY 2011, 2012 and 2013.

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Annual Cost to Federal Government: $136,368

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: 02/12/2015

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