Gravesite Reservation Questionnaire (2 Year)

Forms and Documents

Document Name	Status
Form FL 40-40 Gravesite Reservation Questionnaire (2 Year) Form and Instruction	Modified
2900-0546 30Day FRN.pdf Supplementary Document	2017-06-30
2900-0546 Justification A 06302017.docx Supporting Statement A	2017-06-30

IC Document Collections

IC ID	Document Title	Status
28725	Gravesite Reservation Questionnaire (2 Year) Form and Instruction	Modified

ICR Details

OMB Control No: 2900-0546	ICR Reference No: 201704-2900-007
Status: Historical Active	Previous ICR Reference No: 201308-2900-010
Agency/Subagency: VA	Agency Tracking No: 2900-0546
Title: Gravesite Reservation Questionnaire (2 Year)
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: 09/19/2017
	Date Received in OIRA: 06/30/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2020	36 Months From Approved	09/30/2017
Responses	25,000	0	16,500
Time Burden (Hours)	4,167	0	2,750
Cost Burden (Dollars)	0	0	0

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Abstract: Information is needed to determine if individuals holding gravesite set-asides wish to retain their set-aside or their wish to relinquish it.

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Authorizing Statute(s): US Code: 38 USC 2402 para 6 Name of Law: Gravesite Reservation
   PL: Pub.L. 108 - 183 502 Name of Law: Eligibility of surviving spouses who remarry for burial in national cemeteries
  

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 18540	04/19/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 30006	06/30/2017
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
Gravesite Reservation Questionnaire (2 Year)	FL 40-40	Gravesite Reservation Questionnaire (2 Year)

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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	25,000	16,500	0	0	8,500	0
Annual Time Burden (Hours)	4,167	2,750	0	0	1,417	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: There was an increase in the number of respondents, which increases the burden hour.

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Annual Cost to Federal Government: $25,601

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: 06/30/2017

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