State Cemetery Data Sheet and Cemetery Grant Documents

Forms and Documents

Document Name	Status
Form VA Form 40-0895-9 State Cemetery Data Sheet and Cemetery Grant Documents Form	Modified
VA40-0895-13 2017.pdf Supplementary Document	2017-06-14
2900-0559 Justification June 2017.docx Supporting Statement A	2017-06-14

IC Document Collections

IC ID	Document Title	Status
28741	State Cemetery Data Sheet and Cemetery Grant Documents Form	Modified

ICR Details

OMB Control No: 2900-0559	ICR Reference No: 201602-2900-002
Status: Historical Active	Previous ICR Reference No: 201304-2900-016
Agency/Subagency: VA	Agency Tracking No: 2900-0559
Title: State Cemetery Data Sheet and Cemetery Grant Documents
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/15/2017
	Date Received in OIRA: 09/28/2016
Terms of Clearance: VA will include the expiration date on all newly printed forms, but may continue to exhaust its stock of printed forms without the expiration date.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2020	36 Months From Approved	06/30/2017
Responses	286	0	361
Time Burden (Hours)	10,050	0	14,058
Cost Burden (Dollars)	0	0	0

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Abstract: Information is used by the State Cemetery Grants Service to provide data regarding the number of interments conducted at State Veterans cemeteries and support grant applications each year. This data is necessary for budget and oversight purposes.

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Authorizing Statute(s): PL: Pub.L. 110 - 157 202b Name of Law: Dr. James Allen Veteran Vision Equity Act of 2007
   US Code: 38 USC 501 Name of Law: Rules and regulations
   US Code: 38 USC Section 2408 Name of Law: Aid to States for establishing, expanding and improving veterans' cemeteries
  

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:
	81 FR 15986	07/06/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 23240	09/27/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
State Cemetery Data Sheet and Cemetery Grant Documents	VA Form 40-0895-3, VA Form 40-0895-2, VA Form 40-0895-15, VA Form 40-0895-17, VA Form 40-0895-8, VA Form 40-0895-9, VA Form 40-0895-13, VA 40-0895-10, VA Form 40-0895-7, VA 40-0895-16, VA Form 40-0895-12, VA Form 40-0895-6, 40-0241	Certification Regarding Lobbying ,   Certification of State or Tribal Government Matching Architectural and Engineering Funds to Qualify for Group 1 on the Priority List ,   Certification of Cemetery Maintained in Accordance with National Cemetery Administration Standards ,   Certification Regarding Drug-Free Workplace ,   Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion ,   Certification Regarding Debarment, Suspension and Other Responsibility Matters Primary Covered Transactions - (State or Tribal Government) ,   State or Tribal Government Cemetery Plan Preparation ,   State or Tribal Government Cemetery Documentation of Grant Accomplishments ,   State or Tribal Government Cemetery Grants Service Space Program Analysis - Buildings ,   State Cemetery Data ,   Certification of Compliance ,   Certification with Provisions of the Davis-Bacon Act ,   Certification Regarding Documents and Information for State or Tribal Government Cemetery Construction Grants - Post Grant Requirements

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ICR Summary 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	286	361	0	0	-75	0
Annual Time Burden (Hours)	10,050	14,058	0	0	-4,008	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The decrease in burden hours is due to the reduction of Cemetery Grants awarded in 2015.

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Annual Cost to Federal Government: $8,179

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: 09/28/2016

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