Request for Retroactive Induction for a Period Previously Completed Under Chapter 33 (VA Form 28-10286)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form VA Form 28-10286 Request For Retroactive Induction For A Period Previously Completed Under Chapter 33 (Chapter 31- Veteran Readiness and Employment)	Form	New	Repair queued
SupportingStatement (2900-NEW).docx	Supporting Statement A	Uploaded 2023-09-11	Available
2023-19394.pdf	Supplementary Document	Uploaded 2023-09-11	Missing upstream
2023-14032.pdf	Supplementary Document	Uploaded 2023-07-10	Missing upstream

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
260856	Request For Retroactive Induction For A Period Previously Completed Under Chapter 33 (Chapter 31- Veteran Readiness and Employment)	Form	New

ICR Details

OMB Control No:	ICR Reference No: 202306-2900-019
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: VA	Agency Tracking No: VBA-VRE-NK
Title: Request for Retroactive Induction for a Period Previously Completed Under Chapter 33 (VA Form 28-10286)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/11/2023

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	99,000	0
Time Burden (Hours)	33,000	0
Cost Burden (Dollars)	0	0

---

Abstract: A service member or veteran will use VA Form 28-10286 to request a retroactive induction for a period previously completed under Chapter 33 benefits. The VR&E program subsequently uses the information on this form to determine if a service member or veteran qualifies for restoration of entitlement. Without the information gathered on this form, the VR&E program would be unable to verify that the service member or veteran meets the criteria for retroactive induction.

---

Authorizing Statute(s): US Code: 38 USC 3102 Name of Law: Basic Entitlement
   US Code: 38 USC 3103 Name of Law: Periods of Eligibility
   US Code: 38 USC 3108 Name of Law: Allowances
   US Code: 38 USC 5113 Name of Law: Effective Dates of Educational Benefits
  

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:
	88 FR 14032	07/03/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 19394	09/08/2023
Did the Agency receive public comments on this ICR? Yes

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Request For Retroactive Induction For A Period Previously Completed Under Chapter 33 (Chapter 31- Veteran Readiness and Employment)	VA Form 28-10286	Request for Retroactive Induction for a Period Previously Completed Under Chapter 33

---

ICR Summary of Burden

table that charts list of burden

	Total Request	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	99,000	0	0	99,000	0	0
Annual Time Burden (Hours)	33,000	0	0	33,000	0	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: This is a new collection.

---

Annual Cost to Federal Government: $4,481,477

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

---

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: 09/11/2023

---