OMB Notice of Action 2900-0784

NOTICE OF OFFICE OF MANAGEMENT AND BUDGET ACTION
Date

04/23/2020

Department of Veterans Affairs

FOR CERTIFYING OFFICIAL:

James Gfrerer

FOR CLEARANCE OFFICER:

Cynthia Harvey-Pryor

In accordance with the Paperwork Reduction Act, OMB has taken action on your request received
10/22/2019
ACTION REQUESTED:

Revision of a currently approved collection

TYPE OF REVIEW REQUESTED:

Regular

ICR REFERENCE NUMBER:

201908-2900-005

AGENCY ICR TRACKING NUMBER:
TITLE:

NCA PreNeed Burial Planning

LIST OF INFORMATION COLLECTIONS: See next page
OMB ACTION: Approved with change
OMB CONTROL NUMBER:

2900-0784

The agency is required to display the OMB Control Number and inform respondents of its legal significance in
accordance with 5 CFR 1320.5(b).
EXPIRATION DATE: 04/30/2023

BURDEN:

DISCONTINUE DATE:

RESPONSES

HOURS

COSTS

Previous

36,000

12,000

0

New

47,400

15,800

0

0

0

0

11,400

3,800

0

Change due to Agency Adjustment

0

0

0

Change due to PRA Violation

0

0

0

Difference
Change due to New Statute
Change due to Agency Discretion

TERMS OF CLEARANCE:

Within 120 days of approval, VA provide updated screenshots of the electronic version of this
form.

OMB Authorizing Official:

Dominic J. Mancini
Deputy and Acting Administrator,
Office Of Information And Regulatory Affairs

List of ICs
IC Title
NCA PreNeed Burial Planning 40-10007

Form No.

Form Name
Preneed Burial Planning

CFR Citation