Verification of Eligibility for Burial in a National Cemetery

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form V40-4962 Verification of Eligibility for Burial in a National Cemetery	Form	Modified	Available
Form V40-4962 Verification of Eligibility for Burial in a National Cemetery	Form	Modified	Repair queued
Non-Substantive Change Request OMB Control Number 2900-0232.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-04-28	Available
Non-Substantive Change Request OMB Control Number 2900-0232.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-04-28	Missing upstream
OMB 2900-0232 PRA Statement_Final Rule_ 7-31-2023.docx	Supporting Statement A	Uploaded 2023-08-03	Available
OMB 2900-0232 PRA Statement_Final Rule_ 7-31-2023.docx	Supporting Statement A	Uploaded 2023-08-03	Repair queued
Description of Changes to VA Form 40-4962 (OMB #2900-0232) 8172022.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-08-19	Available
Description of Changes to VA Form 40-4962 (OMB #2900-0232) 8172022.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-08-19	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
28474	Verification of Eligibility for Burial in a National Cemetery	Form	Modified	Verification of Eligibility for Burial in a National Cemetery
28474	Verification of Eligibility for Burial in a National Cemetery	Form	Modified

ICR Details

OMB Control No: 2900-0232	ICR Reference No: 202504-2900-015
Status: Active	Previous ICR Reference No: 202308-2900-002
Agency/Subagency: VA	Agency Tracking No:
Title: Verification of Eligibility for Burial in a National Cemetery
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 without change	Conclusion Date: 05/02/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/28/2025
Terms of Clearance: This request is approved to revise questions to align with E.O. 14168 Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2026	08/31/2026	08/31/2026
Responses	150,000	0	150,000
Time Burden (Hours)	37,500	0	37,500
Cost Burden (Dollars)	0	0	0

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Abstract: VA requires applicants for national cemetery burial to provide information to verify eligibility for burial in a national cemetery, to schedule interment and to provide services requested by the decedent’s family or personal representative. This information is also used for planning and scheduling cemetery services and to provide for specific requests from family members or the personal representative.

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Authorizing Statute(s): US Code: 38 USC 2402
   PL: Pub.L. 103 - 446 509 Name of Law: Center for Minority Veterans and Center for Women Veterans
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
2900-AR80	Final or interim final rulemaking	88 FR 51236	08/03/2023

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Federal Register Notices & Comments

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
Verification of Eligibility for Burial in a National Cemetery	V40-4962	Verification of Eligibility for Burial in a National Cemetery

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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	150,000	150,000	0	0	0	0
Annual Time Burden (Hours)	37,500	37,500	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:

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Annual Cost to Federal Government: $2,844,000

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: 04/28/2025

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