Supporting Statement(2900-0734)

SUPPORTING STATEMENT - Part A

VA Form 27-0820, Report of General Information

VA Form 27-0820a, Report of First Notice of Death

VA Form 27-0820b, Report of Nursing Home or Assisted Living Information

VA Form 27-0820c, Report of Defense Finance and Accounting Service (DFAS)

VA Form 27-0820d, Report of Non-Receipt of Payment

VA Form 27-0820e, Report of Incarceration

VA Form 27-0820f, Report of Month of Death

2900-0734

Summary of Changes:

• This ICR is being submitted as an “Extension” since there are no changes to the burden or the information collection instruments.

• No comments were received in response to the 60-Day FRN.

• This information collection request (ICR) package includes VA Forms 27-0820, 27-0820a, 27-0820b, 27-0820c, 27-0820d, 27-0820e, 27-0820f.

• Titles: Report of General Information, Report of First Notice of Death, Report of Nursing Home or Assisted Living Information, Report of Defense Finance and Accounting Service (DFAS), Report of Non-Receipt of Payment, Report of Incarceration, Report of Month of Death.

1. Need for the Information Collection

The Department of Veterans Affairs (VA) through its Veterans Benefits Administration (VBA), administers an integrated program of benefits and services, established by law, for veterans, service personnel, and their dependents and/or beneficiaries. The 38 Code of Federal Regulations 3.217 provides that action affecting entitlement to benefits may be taken based on oral information or statements provided to VA by a beneficiary or his or her fiduciary.

2. Use of the Information

VA Forms 27-0820, 27-0820a, 27-0820b, 27-0820c, 27-0820d, 27-0820e and 27-0820f will be used by VA Regional Office and Pension Maintenance Center employees to meet VA’s requirement to document verbal evidence obtained telephonically from VA beneficiary or claimant that will be used as part of the evidence for a claim for benefits. Without this information action cannot be taken on any information received orally.

3. Use of the Information Technology

VA Forms 27-0820, 27-0820a, 27-0820b, 27-0820c, 27-0820d, 27-0820e and 27-0820f are available on the va.gov web site in a fillable electronic format and VBA’s Virtual VA application. VBA maintains a secure server for forms of this type but does not currently have the technology in place to allow for the complete submission of the form. Validation edits are performed to assure data integrity. Efforts within VA are underway to provide a mechanism to allow the information to be submitted electronically with a recognized signature technology. There currently is no utility process in place that will allow the data submitted on the form to be incorporated with an existing centralized legacy database.

4. Non-Duplication

There is no duplication associated with this collection of duplication.

5. Burden on Small Businesses

The collection of information does not involve small businesses or entities.

6. Less Frequent Collection

Without this information, entitlement to benefits may be delayed or could not be determined.

7. Paperwork Reduction Act Guidelines

There are no special circumstances requiring that the collection of information be conducted in a manner inconsistent with guidelines in 5 CFR Section 1320.6.

8. Consultation and Public Comments

Part A: PUBLIC NOTICE:

A 60-Day Federal Register Notice (FRN) for the collection published on Friday, October, 4, 2024. The 60-Day FRN citation is 89 FRN 80990-80991.

A 30-Day Federal Register Notice for the collection published on Friday, December 6, 2024. The 30-Day FRN citation is 89 FRN 97172.

Part B: CONSULTATION:

No additional consultation apart from soliciting public comments through the Federal Register was conducted for this submission.

9. Gifts or Payment

No payments or gifts are being offered to respondents as an incentive to participate in this collection of information.

10. Confidentiality

The records are maintained in the appropriate Privacy Act System of Records identified as “Compensation, Pension, Education, and Veteran Readiness and Employment Records – VA (58VA21/22/28), published at 74 FR 29275 on June 19, 2009, and last amended at 87 FR 8740 (February 16, 2022).

11. Sensitive Questions

There are no questions of a sensitive nature.

12. Respondent Burden and its Labor Costs

1. Number of Respondents: 2,550,000.

b. Frequency of Response: One time.

c. Annual Burden Hours: 212,500.

d. Estimated Completion Time: 5 minutes.

e. VA cannot make further assumptions about the population of respondents because of the variability of factors such as the educational background and wage potential of respondents. Therefore, VBA used general wage data to estimate the respondents’ costs associated with completing the information collection.

The Bureau of Labor Statistics (BLS) gathers information on full-time wage and salary workers. According to the latest available BLS data, the mean weakly earnings of full-time wage and salary workers is $1,259.20. Assuming a forty (40) hour work week, the mean hourly wage is $31.48 based on the BLS wage code – “00-0000 All Occupations.” This information was taken from the following website: (https://www.bls.gov/oes/current/oes_nat.htm, May 2023). 

Legally, respondents may not pay a person or business for assistance in completing the information collection and a person or business may not accept payment for assisting a respondent in completing the information collection. Therefore, there are no expected overhead costs for completing the information collection. VBA estimates the total cost to all respondents to be $6,689,500.00 (212,500 burden hours x $31.48 per hour).

13. Respondent Costs Other Than Burden Hour Costs

This submission does not involve any record keeping costs.

14. Costs to the Federal Government

  Estimated Costs to the Federal Government:

Grade	Step	Burden Time	Fraction of Hour	Hourly Rate	Cost Per Response	Total Responses	Total
9	3	5	0.08	$23.55	$1.963	2,550,000	$ 5,004,375.00
Overhead at 100% Salary							$ 5,004,375.00
11	3	5	0.08	$28.50	$2.375	2,550,000	$ 6,056,250.00
Overhead at 100% Salary							$ 6,056,250.00
12	3	5	0.08	$34.16	$2.847	2,550,000	$ 7,259,000.00
Overhead at 100% Salary							$ 7,259,000.00
Processing / Analyzing Costs							$ 36,639,250.00
Printing and Production Cost							$ 1,831.96
Total Cost to Government							$ 36,641,081.96

Overhead costs are 100% of salary and are the same as the wage listed above and the amounts are included in the total.

Printing and production costs approximates the cost of printing this information collection per year. (Processing/Analyzing Cost total divided by $54).

Note: The hourly wage information above is based on the hourly 2024 General Schedule (Base) Pay (https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/24Tables/html/GS_h.aspx).  This rate does not include any locality adjustment as applicable.

The processing time estimates above are based on the actual amount of time employees of each grade level spend to process to completion a claim received on this form. The within-grade step (3) of each employee represents the average experience of employees within each grade.

15. Reason for Change in Burden

There is no change in burden.

16. Publication of Results

This information collection is not for publication.

17. Non-Display of OMB Expiration Date

We are not seeking to omit the expiration date for OMB approval.

18. Exceptions to “Certification for Paperwork Reduction Submissions”

We are not requesting any exemptions to the provisions stated in 5 CFR 1320.9.

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