Application for Burial Benefits (Under 38 U.S.C. Chapter 23) (VA Form 21P-530)

Forms and Documents

Document Name	Status
Form VA Form 21P-530 Application for Burial Benefits (Under 38 U.S.C. Chapter 23) (VA Form 21P-530) Form	Modified
OMB Passback - 2900-0003 Supporting Statement.docx Supporting Statement A	2017-03-28
2900-0003 30-Day FRN.pdf Supplementary Document	2016-08-25
2900-0003 60-Day FRN.pdf Supplementary Document	2016-06-07
2900-0003 Revisions Description.docx Supplementary Document	2016-05-16

IC Document Collections

IC ID	Document Title	Status
28070	Application for Burial Benefits (Under 38 U.S.C. Chapter 23) (VA Form 21P-530) Form	Modified

ICR Details

OMB Control No: 2900-0003	ICR Reference No: 201605-2900-002
Status: Historical Active	Previous ICR Reference No: 201501-2900-012
Agency/Subagency: VA	Agency Tracking No: VBA-P&F-YM
Title: Application for Burial Benefits (Under 38 U.S.C. Chapter 23) (VA Form 21P-530)
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: 04/03/2017
	Date Received in OIRA: 08/26/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2020	36 Months From Approved	06/30/2017
Responses	135,000	0	150,000
Time Burden (Hours)	33,750	0	37,500
Cost Burden (Dollars)	702,000	0	0

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Abstract: VA Form 21P-530 is necessary to determine whether burial benefits are payable and, if so, to whom. The benefit could not be properly paid without this information.

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Authorizing Statute(s): US Code: 38 USC 2302 Name of Law: Funeral expenses
   US Code: 38 USC 2303 Name of Law: Death in Department facility; plot allowance
   US Code: 38 USC 2304 Name of Law: Claims for Reimbursement
   US Code: 38 USC 2307 Name of Law: Death from service-connected disability
   US Code: 38 USC 2308 Name of Law: Transportation of deceased Veteran to a national cemetery
  

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 36658	06/07/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 58557	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
Application for Burial Benefits (Under 38 U.S.C. Chapter 23) (VA Form 21P-530)	VA Form 21P-530	Application for Burial Benefits (Under 38 U.S.C. Chapter 23)

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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	135,000	150,000	0	-15,000	0	0
Annual Time Burden (Hours)	33,750	37,500	0	-3,750	0	0
Annual Cost Burden (Dollars)	702,000	0	0	0	702,000	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: Using Information Technology

Short Statement: VBA implemented automation procedures which resulted in burial benefits being paid to approximately 30,000 beneficiaries per year without the need for the beneficiary to submit an application. Some beneficiaries who receive these automatic payments subsequently submit an application to claim a higher amount of reimbursement than what they received. Therefore, VA did not identify a 1-to-1 reduction in the number of applications received. 135,000 responses represents the actual number of applications received in a given 12 month period.

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Annual Cost to Federal Government: $5,908,050

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: 08/26/2016

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