Presidential Memorial Certificate (PMC)

Forms and Documents

Document Name	Status
Form VA40-0247 Presidential Memorial Certificate (PMC) Form and Instruction	Modified
OMB Justification 2900-0567 July 2017.docx Supporting Statement A	2017-07-28
VA40-0247(draft)March 2017.pdf Supplementary Document	2017-03-09

IC Document Collections

IC ID	Document Title	Status
28757	Presidential Memorial Certificate (PMC) Form and Instruction	Modified

ICR Details

OMB Control No: 2900-0567	ICR Reference No: 201611-2900-011
Status: Historical Active	Previous ICR Reference No: 201309-2900-020
Agency/Subagency: VA	Agency Tracking No: 2900-0567
Title: Presidential Memorial Certificate (PMC)
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: 10/25/2017
	Date Received in OIRA: 07/28/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2020	36 Months From Approved	10/31/2017
Responses	125,000	0	183,453
Time Burden (Hours)	6,250	0	6,115
Cost Burden (Dollars)	0	0	0

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Abstract: Information is used to provide additional certificates requested by respondent. A respondent is an eligible recipient that includes the next-of-kin, other relatives or friends that request additional certificates and/or replacement certificates.

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Authorizing Statute(s): US Code: 38 USC Section 112 Name of Law: Presidential memorial certificate program
   US Code: 38 USC Section 2411 Name of Law: The Dignified Burial and Other Veterans' Benefits Improvement Act of 2012
  

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:
	82 FR 6728	01/19/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 16475	05/04/2017
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
Presidential Memorial Certificate (PMC)	VA40-0247	Presidential Memorial Certificate Request Form

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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	125,000	183,453	0	0	-58,453	0
Annual Time Burden (Hours)	6,250	6,115	0	0	135	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: The burden hour shown represents an estimated reduction in the total burden hours for a full year period. It is proposed that this reduction is the result of better accessibility to the form via the internet, the ability to accurately complete the form while on line. It is also noted that by estimating a fixed number of monthly responses (using a fixed average monthly response rate) across a twelve month period this also contributes to the reduced overall total shown.

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Annual Cost to Federal Government: $607,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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: 07/28/2017

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