Financial Status Report

DEPARTMENT OF VETERANS AFFAIRS Billing Code 8320-01

[OMB Control No. 2900-0165]

Agency Information Collection (Financial Status Report) Activities under OMB Review

AGENCY: The Office of Management, Department of Veterans Affairs

ACTION: Notice.

SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice announces that The Office of Management, Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden; it includes the actual data collection instrument.

DATE: Comments must be submitted on or before [Insert date 30 days after date of publication in the FEDERAL REGISTER].

ADDRESSES: Submit written comments on the collection of information through www.Regulations.gov, or to Office of Information and Regulatory Affairs, Office of Management and Budget, Attn: VA Desk Officer; 725 17th St. NW., Washington, DC 20503 or sent through electronic mail to [email protected]. Please refer to ‘‘OMB Control No. 2900–0165” in any correspondence. During the comment period, comments may be viewed online through the FDMS.

FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, (202) 632–7492 or email [email protected]. Please refer to ‘‘OMB Control No. 2900–0165” in any correspondence.

SUPPLEMENTAL INFORMATION:

Title: Financial Status Report

OMB Control Number: 2900-0165.

Type of Review: Extension of a currently approved collection.

Abstract: Claimants complete VA Form 5655 to report their financial status. VA
uses the data collected to determine the claimant’s eligibility for a waiver of collection, setup a payment plan or for the acceptance of a compromise offer on their VA
benefit debt.

An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The Federal Register Notice with a 60-day comment period soliciting comments on this collection of information was published on February 10, 2015, at page 7530.

Affected Public: Individuals and Households.

Estimated Annual Burden: 95,570 hours.

Estimated Average Burden Per Respondent: 1 hour.

Frequency of Response: Annually.

Estimated Number of Respondents: 95,570.

DATED:

By direction of the Secretary:

_____________________________________

Crystal Rennie,

VA Clearance Officer

Department of Veterans Affairs

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