Request for Information to Make Direct Payment to Child Reaching Majority (FL21-863)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FL21-863 Request for Information to Make Direct Payment to Child Reaching Majority (FL21-863)	Form	Modified	Available
30-Day FRN (OMB 2900-0215) Published_03_07_17.pdf	Supplementary Document	Uploaded 2017-03-07	Available
2900-0215 Supporting Statement for FL 21-863 (1-19-17).docx	Supporting Statement A	Uploaded 2017-01-19	Available
60-Day FRN (OMB 2900-0215) Published_12_14_16.pdf	Supplementary Document	Uploaded 2016-12-16	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
28461	Request for Information to Make Direct Payment to Child Reaching Majority (FL21-863)	Form	Modified	Request for Information to Make Direct Payment to Child Reaching Majority (FL21-863)

ICR Details

OMB Control No: 2900-0215	ICR Reference No: 201610-2900-007
Status: Historical Active	Previous ICR Reference No: 201312-2900-016
Agency/Subagency: VA	Agency Tracking No: VBA-COMP-DJ
Title: Request for Information to Make Direct Payment to Child Reaching Majority (FL21-863)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/17/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/13/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2020	36 Months From Approved	09/30/2017
Responses	20	0	20
Time Burden (Hours)	3	0	3
Cost Burden (Dollars)	0	0	0

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Abstract: VA Form Letter 21-863 is used to gather the necessary information to determine a school child's continued eligibility to VA death benefits and eligibility to direct payment at the age of majority.

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Authorizing Statute(s): US Code: 38 USC 1313 Name of Law: Dependency and indemnity compensation to children
   US Code: 38 USC 1542 Name of Law: Children of veterans of a period of war
   US Code: 38 USC 101(4) Name of Law: Definitions
   US Code: 38 USC 1310 Name of Law: Deaths entitling survivors to dependency and indemnity compensation
  

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 90412	12/14/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 12917	03/07/2017
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Request for Information to Make Direct Payment to Child Reaching Majority (FL21-863)	FL21-863	Request for Information to Make Direct Payment to Child Reaching Majority (FL21-863)

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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	20	20	0	0	0	0
Annual Time Burden (Hours)	3	3	0	0	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: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $1,413

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: 04/13/2017

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