Dependents' Educational Assistance (DEA) Election Request (FL 22-909)

Forms and Documents

Document Name	Status
Form VA FL 22-909 Dependents' Educational Assistance (DEA) Election Request Form	Modified
Justification 2900-0703 Clean.docx Supporting Statement A	2017-04-19

IC Document Collections

IC ID	Document Title	Status
181094	Dependents' Educational Assistance (DEA) Election Request Form	Modified

ICR Details

OMB Control No: 2900-0703	ICR Reference No: 201602-2900-034
Status: Historical Active	Previous ICR Reference No: 201302-2900-011
Agency/Subagency: VA	Agency Tracking No: VBA-EDU-NK
Title: Dependents' Educational Assistance (DEA) Election Request (FL 22-909)
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: 04/26/2017
	Date Received in OIRA: 11/02/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2020	36 Months From Approved	04/30/2017
Responses	384	0	735
Time Burden (Hours)	96	0	184
Cost Burden (Dollars)	0	0	0

---

Abstract: The VA FL 22-909 is used to request an election of the eligibility period beginning date from dependents of veterans who qualify under DEA (38 U.S.C. chapter 35). Statute requires VA to provide some dependents the right to elect the beginning date. This election is not mandatory, but may benefit the dependent.

---

Authorizing Statute(s): US Code: 38 USC 3512(a) and (b) Name of Law: Periods of eligibility
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 15985	07/06/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 24155	10/06/2016
Did the Agency receive public comments on this ICR? No

---

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

IC Title	Form No.	Form Name
Dependents' Educational Assistance (DEA) Election Request	VA FL 22-909	Dependents' Educational Assistance (DEA) Election Request

---

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	384	735	0	-351	0	0
Annual Time Burden (Hours)	96	184	0	-88	0	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 a decrease in the number of individuals applying for DEA benefits.

---

Annual Cost to Federal Government: $1,702

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

---

Common Form ICR:  No

---

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: 11/02/2016

---