Adaptive Sport Grant Application

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form VA 10096 Adaptive Sports Grant Application	Form	New	Available
Justification FY16 VA Form 10096_021916.docx	Supporting Statement A	Uploaded 2016-02-19	Available
Adaptive Sports Grant Application 30-day FRN (CR 12.10.15) (CR 1.14.16).docx	Supplementary Document	Uploaded 2016-01-14	Available
60-Day FRN Adaptive Sports Grant Application.docx	Supplementary Document	Uploaded 2015-07-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
215773	38 CFR 77 Report Template		New
215772	Adaptive Sports Grant Application	Form	New

ICR Details

OMB Control No: 2900-0845	ICR Reference No: 201501-2900-009
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: VA	Agency Tracking No:
Title: Adaptive Sport Grant Application
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 without change	Conclusion Date: 05/09/2016
	Date Received in OIRA: 02/22/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2019	36 Months From Approved
Responses	1,150	0	0
Time Burden (Hours)	2,133	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Grants for Adaptive Sports Programs for disabled Veterans and Members of the Armed Forces (ASG Program) provides grant funding to organizations to increase and expand the quantity and quality of adaptive sport activities disabled Veterans and members of the Armed Forces have to participate in physical activity within their home communities, as well as more advanced Paralympic and adaptive sport programs at the regional and national levels. This application will be submitted to the Department of Veterans Affairs office of National Veterans Sports Programs and Special Events for those wishing to participate in the ASG program.

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Authorizing Statute(s): US Code: 38 USC 521A Name of Law: Veterans' Benefits Improvement Act of 2008, Section 703
  

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:
	80 FR 58814	09/30/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 3242	01/20/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Adaptive Sports Grant Application	VA 10096	Adaptive Sports Grant Application
38 CFR 77 Report Template

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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	1,150	0	0	1,150	0	0
Annual Time Burden (Hours)	2,133	0	0	2,133	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 a new data collection. All hours are considered a burden increase.

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Annual Cost to Federal Government: $8,257,695

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: 02/22/2016

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