Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant (VA Form 26-4555)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 26-4555 Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant (Title 38 U.S.C. Section 2101(a) or 2101(b))	Form	Modified	Available
Form VA Form 26-4555 Veteran's Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant	Form	Modified	Available
Supporting Statement (2900-0132).docx	Supporting Statement A	Uploaded 2026-07-10	Available
Public Comment Notice VA-2026-VACO-0001.pdf	Public Comments	Uploaded 2026-05-15	Available
OMB 2900-0132_LGY Public Comment Response_Signed.pdf	Public Comments	Uploaded 2026-07-10	Available
2900-0132_30-Day FRN_Published.pdf	Supplementary Document	Uploaded 2026-07-10	Available
60-Day (published) 2900-0132.pdf	Supplementary Document	Uploaded 2026-07-07	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
28354	Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant (Title 38 U.S.C. Section 2101(a) or 2101(b))	Form	Modified	Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant (Title 38 U.S.C. Section 2101(a) or 2101(b))
28354	Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant (Title 38 U.S.C. Section 2101(a) or 2101(b))	Form	Modified	Veteran's Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant
28354	Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant (Title 38 U.S.C. Section 2101(a) or 2101(b))	Other-Verification Documents	Modified

ICR Details

OMB Control No: 2900-0132	ICR Reference No: 202509-2900-004
Status: Received in OIRA	Previous ICR Reference No: 202311-2900-001
Agency/Subagency: VA	Agency Tracking No: VBA-LGY-KM
Title: Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant (VA Form 26-4555)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 07/10/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	05/31/2027
Responses	11,200	7,000
Time Burden (Hours)	4,293	1,167
Cost Burden (Dollars)	0	0

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Abstract: VA Form 26-4555 is used to gather information necessary to determine the eligibility for the veteran or servicemember for specially adapted housing or for a special home adaptation grant.

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Authorizing Statute(s): US Code: 38 USC 2101 Name of Law: Veterans Eligible For Assistance
  

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:
	91 FR 24034	05/04/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 42790	07/10/2026
Did the Agency receive public comments on this ICR? Yes

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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
Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant (Title 38 U.S.C. Section 2101(a) or 2101(b))	VA Form 26-4555, 26-4555	Veteran's Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant ,   Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant (Title 38 U.S.C. Section 2101(a) or 2101(b))

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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	11,200	7,000	0	4,200	0	0
Annual Time Burden (Hours)	4,293	1,167	0	3,126	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: The estimated respondent burden has increased to account for documentation requirements associated with construction and adaptation activities, which increased the number of participating respondents from 7,000 to 11,200 and, in turn, increased the total annual burden hours.

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Annual Cost to Federal Government: $105,840

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: 07/10/2026

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