VA National Veterans Sports Programs and Special Events

Forms and Documents

Document Name	Status
Form Web Survey: VA For VA National Veterans Sports Programs and Special Events Surveys Form	Modified
30-day 2900-0818_2017-16124.pdf Supplementary Document	2017-07-31
2900-0818 60-day FRN.pdf Supplementary Document	2017-07-26
2900-0818 NVSPSE Survey Justification B.docx Supporting Statement B	2017-07-27
2900-0818 NVSPSE Survey Justification A .docx Supporting Statement A	2017-07-27

IC Document Collections

IC ID	Document Title	Status
209677	VA National Veterans Sports Programs and Special Events Surveys Form	Modified

ICR Details

OMB Control No: 2900-0818	ICR Reference No: 201705-2900-008
Status: Historical Active	Previous ICR Reference No: 201312-2900-011
Agency/Subagency: VA	Agency Tracking No:
Title: VA National Veterans Sports Programs and Special Events
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: 11/14/2017
	Date Received in OIRA: 07/31/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2020	36 Months From Approved	11/30/2017
Responses	4,550	0	4,550
Time Burden (Hours)	193	0	193
Cost Burden (Dollars)	0	0	0

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Abstract: The Department of Veterans Affairs (VA) administers National Rehabilitation Special Events for Veterans who are receiving care at VA medical facilities. Each event promotes the healing of body and spirit by motivating eligible Veterans to reach their full potential, improve their independence, achieve a healthier lifestyle and enjoy a higher quality of life. The surveys are designed to allow program improvement and measure the tangible, quantifiable benefits of the events using event applications. Information collected on these applications is used for the planning, distribution and utilization of resources and to allocate clinical and administrative support to patient treatment services.

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Authorizing Statute(s): US Code: 38 USC Part 1, Chapter 5, Section 527 Name of Law: Evaluation and Data Collection
  

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 32135	05/19/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 16124	07/31/2017
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
VA National Veterans Sports Programs and Special Events Surveys	Web Survey: VA Form 10107, Web Survey: VA Form 10108, Web Survey: VA Form 10109, Web Survey: VA Form 10110, Web Survey: VA Form 10111, Web Survey: VA Form 10112	National Disabled Veterans Winter Sports Clinic (NDVWSC) ,   National Veterans Creative Arts Festival (NVCAF) ,   National Veterans Golden Age Games (NVGAG) ,   National Veterans Summer Sports Clinic (NVSSC) ,   National Veterans TEE Tournament (NVTEE) ,   National Veterans Wheelchair Games (NVWG)

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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	4,550	4,550	0	0	0	0
Annual Time Burden (Hours)	193	193	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: $300

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 07/31/2017

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