Certificate of Delivery of Advance Payment and Enrollment (VA Form 22-1999v)

Forms and Documents

Document Name	Status
Form 22-1999v Certificate of Delivery of Advance Payment and Enrollment Form	Modified
60-day FRN - 2900-0325 (2016).pdf Supplementary Document	2016-07-13
Justification for 2900-0325 Vet or Depdnt 2016.docx Supporting Statement A	2016-09-21

IC Document Collections

IC ID	Document Title	Status
28544	Certificate of Delivery of Advance Payment and Enrollment Form	Modified

ICR Details

OMB Control No: 2900-0325	ICR Reference No: 201604-2900-012
Status: Historical Active	Previous ICR Reference No: 201603-2900-012
Agency/Subagency: VA	Agency Tracking No: VBA-EDU-YM
Title: Certificate of Delivery of Advance Payment and Enrollment (VA Form 22-1999v)
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: 01/10/2017
	Date Received in OIRA: 09/21/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2020	36 Months From Approved	01/31/2017
Responses	1,465	0	700
Time Burden (Hours)	122	0	58
Cost Burden (Dollars)	0	0	0

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Abstract: This form is used by schools to certify delivery of advance payments and to report any changes in enrollment status. VA uses the information to remove a computer control temporarily preventing future payments of benefits and to process receipt of advance payments.

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Authorizing Statute(s): US Code: 38 USC 3531 Name of Law: Educational Assistance Benefits
   US Code: 38 USC 3034 Name of Law: Program Administration
   US Code: 38 USC 3680 Name of Law: Payment of educational assistance or subsistence allowances
   US Code: 38 USC 3684 Name of Law: Reports by veterans, eligible persons, and institution; reporting fee
   US Code: 10 USC 16136 Name of Law: Administration of Program
   US Code: 10 USC 510 Name of Law: Enlistment incentives for pursuit of skills to facilitate national service
   US Code: 10 USC 16166 Name of Law: Administration of Program
   US Code: 38 USC 3241 Name of Law: Requirements
   PL: Pub.L. 96 - 342 903 Name of Law: null
  

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 14680	06/22/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 20340	08/25/2016
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
Certificate of Delivery of Advance Payment and Enrollment	22-1999v	Certificate of Delivery of Advance Payment and Enrollment

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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	1,465	700	0	765	0	0
Annual Time Burden (Hours)	122	58	0	64	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 requested burden estimate is 122 hours which has increased due to an increase in the number of applications received over FY’s 2013, 2014 and 2015.

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Annual Cost to Federal Government: $7,430

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: 09/21/2016

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