Dependent's Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.) (VA Form 22-5495)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 22-5495 Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)	Form	Modified	Repair queued
30-Day FRN - 2900-0099 (2023).pdf	Supplementary Document	Uploaded 2023-02-10	Repair queued
60-DAY FEDERAL REGISTER NOTICE - ACTUAL.pdf	Supplementary Document	Uploaded 2022-12-06	Repair queued
SUPPORTING STATEMENT 2022-FINAL 112922.docx	Supporting Statement A	Uploaded 2023-01-23	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
28273	Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)	Form	Modified

ICR Details

OMB Control No: 2900-0099	ICR Reference No: 202211-2900-018
Status: Historical Active	Previous ICR Reference No: 202007-2900-017
Agency/Subagency: VA	Agency Tracking No: VBA-EDU-YA
Title: Dependent's Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.) (VA Form 22-5495)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/15/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/10/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2026	36 Months From Approved	03/31/2023
Responses	45,434	0	109,760
Time Burden (Hours)	11,358	0	27,440
Cost Burden (Dollars)	0	0	0

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Abstract: Surviving spouses, spouses, and children of veterans send VA the VA Form 22-5495 to apply for a change of their program of education and/or a new place of training under 38 U.S.C. chapter 35. VA uses the information on the form to determine the current eligibility of the claimant for educational assistance for the new program of education or new place of training. VA uses the information collection to determine (1) if the claimant continues to qualify for education benefits when taking a different program of training and (2) to verify that a new place of training is approved for benefits. The information on the form can be obtained only from the individual claimant. VA cannot make an eligibility determination without this information.

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Authorizing Statute(s): US Code: 38 USC 3521 Name of Law: Approval of Application
   US Code: 38 USC 3513 Name of Law: Application
   US Code: 38 USC 3691 Name of Law: Change of Program
   US Code: 38 USC 3323(a) Name of Law: Administration
   US Code: 38 USC 3034(a) Name of Law: Program Administration
  

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:
	87 FR 74698	12/06/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 8992	02/10/2023
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)	22-5495	Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)

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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	45,434	109,760	0	-64,326	0	0
Annual Time Burden (Hours)	11,358	27,440	0	-16,082	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There is a decrease in the number of burden hours due to a decrease in the average number of forms received for periods 2019, 2020 and 2021

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Annual Cost to Federal Government: $352,340

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? No

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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: 02/10/2023

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