Readjustment Counseling Service Scholarship Program (RCSSP)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 10-264M Mobility Agreement	Form and Instruction	Modified	Available
Form 10-264K Scholarship Offer Response	Form and Instruction	Modified	Repair queued
Form 10-264J Request for Deferment	Form and Instruction	Modified	Available
Form 10-264I Notice of Change and-or Academic Status	Form and Instruction	Modified	Available
Form 10-264H Notice of Approaching Graduation	Form and Instruction	Modified	Available
Form 10-264F Scholarship Agreement	Form and Instruction	Modified	Repair queued
Form 19-264D Education Program Completion Notice	Form and Instruction	Modified	Available
Form 10-264M Mobility Agreement	Form and Instruction	Modified	Available
Form 10-264K Scholarship Offer Response	Form and Instruction	Modified	Available
Form 10-264J Request for Deferment	Form and Instruction	Modified	Available
Form 10-264I Notice of Change and-or Academic Status	Form and Instruction	Modified	Available
Form 10-264H Notice of Approaching Graduation	Form and Instruction	Modified	Available
Form 10-264F Scholarship Agreement	Form and Instruction	Modified	Available
Form 19-264D Education Program Completion Notice	Form and Instruction	Modified	Available
Form 10-264G Application	Form and Instruction	Modified	Repair queued
Form 10-264E Evaluation and Recommendation	Form and Instruction	Modified	Available
Form 10-264A Addendum to Application	Form and Instruction	Modified	Available
Form 10-264 Academic Verification	Form and Instruction	Modified	Available
Form 10-264G Application	Form and Instruction	Modified	Available
Form 10-264E Evaluation and Recommendation	Form and Instruction	Modified	Available
Form 10-264A Addendum to Application	Form and Instruction	Modified	Available
Form 10-264 Academic Verification	Form and Instruction	Modified	Available
30-day FRN_2900-0899_RCS Scholarship Program_published 04232026.pdf	Supplementary Document	Uploaded 2026-04-23	Available
30-day FRN_2900-0899_RCS Scholarship Program_published 04232026.pdf	Supplementary Document	Uploaded 2026-04-23	Available
60-day FRN_2900-0899_RCS Scholarship Program_published 02042026.pdf	Supplementary Document	Uploaded 2026-03-02	Repair queued
60-day FRN_2900-0899_RCS Scholarship Program_published 02042026.pdf	Supplementary Document	Uploaded 2026-03-02	Available
SSA_2900-0899_RCS Scholarship Program (RCSSP)_updated Apr 2026.docx	Supporting Statement A	Uploaded 2026-04-23	Available
SSA_2900-0899_RCS Scholarship Program (RCSSP)_updated Apr 2026.docx	Supporting Statement A	Uploaded 2026-04-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
250256	Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	Form and Instruction	Modified	Mobility Agreement
250256	Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	Form and Instruction	Modified	Scholarship Offer Response
250256	Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	Form and Instruction	Modified	Request for Deferment
250256	Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	Form and Instruction	Modified	Notice of Change and-or Academic Status
250256	Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	Form and Instruction	Modified	Notice of Approaching Graduation
250256	Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	Form and Instruction	Modified	Scholarship Agreement
250256	Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	Form and Instruction	Modified	Education Program Completion Notice
250256	Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	Form and Instruction	Modified	Mobility Agreement
250256	Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	Form and Instruction	Modified	Scholarship Offer Response
250256	Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	Form and Instruction	Modified	Request for Deferment
250256	Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	Form and Instruction	Modified	Notice of Change and-or Academic Status
250256	Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	Form and Instruction	Modified	Notice of Approaching Graduation
250256	Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	Form and Instruction	Modified	Scholarship Agreement
250256	Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	Form and Instruction	Modified	Education Program Completion Notice
250254	Readjustment Counseling Service Scholarship Program (RCSSP) - Applicants	Form and Instruction	Modified	Application
250254	Readjustment Counseling Service Scholarship Program (RCSSP) - Applicants	Form and Instruction	Modified	Evaluation and Recommendation
250254	Readjustment Counseling Service Scholarship Program (RCSSP) - Applicants	Form and Instruction	Modified	Addendum to Application
250254	Readjustment Counseling Service Scholarship Program (RCSSP) - Applicants	Form and Instruction	Modified	Academic Verification
250254	Readjustment Counseling Service Scholarship Program (RCSSP) - Applicants	Form and Instruction	Modified	Application
250254	Readjustment Counseling Service Scholarship Program (RCSSP) - Applicants	Form and Instruction	Modified	Evaluation and Recommendation
250254	Readjustment Counseling Service Scholarship Program (RCSSP) - Applicants	Form and Instruction	Modified	Addendum to Application
250254	Readjustment Counseling Service Scholarship Program (RCSSP) - Applicants	Form and Instruction	Modified	Academic Verification

ICR Details

OMB Control No: 2900-0899	ICR Reference No: 202508-2900-009
Status: Active	Previous ICR Reference No: 202211-2900-010
Agency/Subagency: VA	Agency Tracking No: 2900-0899
Title: Readjustment Counseling Service Scholarship Program (RCSSP)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/26/2026
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/24/2026
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2029	36 Months From Approved
Responses	66	0	0
Time Burden (Hours)	181	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This information collection is necessary due to the mandates of section 502 of Public Law 115-171, the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019, which amended Chapter 76 of title 38 United States Code (U.S.C.) by establishing sections 7698 through 7699B and creating a scholarship program known as the Readjustment Counseling Service Scholarship Program (RCSSP). This legislation authorizes the Department of Veterans Affairs (VA) Readjustment Counseling Service (RCS) to provide scholarship awards to individual Veterans enrolled in accredited academic programs leading to an appointment in one of the selected health professional occupations (psychology, social work, marriage and family therapy, or mental health counseling). The RCSSP serves as an incentive to eligible individuals to further their own career development through completing a graduate degree in one of these four professions. The RCSSP also provides increased access to care for eligible individuals by filling existing vacancies in Vet Centers within population areas with a high level of veteran density and corresponding levels of demand. It is expected that many of these scholarship recipients will continue with VA employment after completion of their service obligation. Further legal authority for this data collection is found under 38 USC, Part I, Chapter 5, Section 527, which authorizes the collection of data that will allow measurement and evaluation of the Department of Veterans Affairs Programs, the goal of which is improved health care for veterans. The information is required to be collected to determine the eligibility or suitability of an applicant desiring to receive an award under the provisions section 502 of Public Law 115-171, the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019. The application forms in this collection are 10-264, 10-264A, 10-264E, and 10-264G. The awardee forms are 10-264D, 10-264F, 10-264H, 10-264I, 10-264J, 10-264K, and 10-264M.

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Authorizing Statute(s): PL: Pub.L. 115 - 171 502 Name of Law: Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019
  

Citations for New Statutory Requirements: PL: Pub.L. 115 - 171 502 Name of Law: CMDR John Scott Hannon Veterans Mental Health Care Improvement Act of 2019

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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:
	91 FR 5158	02/04/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 21873	04/23/2026
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Readjustment Counseling Service Scholarship Program (RCSSP) - Applicants	10-264, 10-264E, 10-264G, 10-264A	Academic Verification ,   Addendum to Application ,   Evaluation and Recommendation ,   Application
Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	10-264F, 19-264D, 10-264H, 10-264I, 10-264J, 10-264K, 10-264M	Education Program Completion Notice ,   Scholarship Agreement ,   Notice of Approaching Graduation ,   Notice of Change and-or Academic Status ,   Request for Deferment ,   Scholarship Offer Response ,   Mobility Agreement

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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	66	0	0	66	0	0
Annual Time Burden (Hours)	181	0	0	181	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: Burden hours have increased based upon program data that demonstrates an increase in the anticipated number of applicants and awardees.

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Annual Cost to Federal Government: $1,318

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: 04/24/2026

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