Yellow Ribbon Program Agreement (22-0839)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form VA Form 22-0839 Yellow Ribbon Program Agreement	Form	Modified	Repair queued
YELLOW RIBBON PROGRAM AGREEMENT Non-Sub Change Draft Adding back POE.docx	Supplementary Document	Uploaded 2020-03-12	Available
YELLOW RIBBON PROGRAM AGREEMENT Non-Sub Change Draft 02 05 2020.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2020-03-06	Available
2900-0718 Supporting Statement Final 9.20.18 RTH.docx	Supporting Statement A	Uploaded 2018-09-27	Available
2900-0718 30 Day FRN.pdf	Supplementary Document	Uploaded 2018-09-26	Available
2900-0718 60Day FRN.pdf	Supplementary Document	Uploaded 2018-09-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
187009	Yellow Ribbon Program Agreement	Form	Modified

ICR Details

OMB Control No: 2900-0718	ICR Reference No: 202003-2900-006
Status: Active	Previous ICR Reference No: 201809-2900-011
Agency/Subagency: VA	Agency Tracking No: 2900-0718 VBA-EDU-YA
Title: Yellow Ribbon Program Agreement (22-0839)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/17/2020
	Date Received in OIRA: 03/06/2020
Terms of Clearance: Approval of this non-substantive/non-material change does not, in and of itself, alter any current agreement between VA and educational institutions. VBA will submit any changes in guidance related to this program to OIRA to review before it becomes effective.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2021	10/31/2021	10/31/2021
Responses	3,372	0	3,372
Time Burden (Hours)	47,208	0	47,208
Cost Burden (Dollars)	0	0	0

---

Abstract: The VA Form 22-0839 will be used by institutions of higher learning (IHLs) to request participation in the Yellow Ribbon Program and provide details of the manner in which the IHL will participate.

---

Authorizing Statute(s): US Code: 38 USC 3317 Name of Law: Public - Private Contribution for Addtional Educational Assistance
   PL: Pub.L. 110 - 252 5003 Name of Law: EDUCATIONAL ASSISTANCE AUTHORIZED
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 2507	02/07/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 9054	04/30/2018
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Yellow Ribbon Program Agreement	VA Form 22-0839	Yellow Ribbon Program Agreement

---

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	3,372	3,372	0	0	0	0
Annual Time Burden (Hours)	47,208	47,208	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:

---

Annual Cost to Federal Government: $86,795

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

---

Common Form ICR:  No

---

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: 03/06/2020

---