PENSION VERIFICATION-INTERVIEW WORKSHEET

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
147860	PENSION VERIFICATION-INTERVIEW WORKSHEET Form	Migrated

ICR Details

OMB Control No: 2900-0271	ICR Reference No: 198104-2900-017
Status: Historical Inactive	Previous ICR Reference No: 197909-2900-002
Agency/Subagency: VA	Agency Tracking No:
Title: PENSION VERIFICATION-INTERVIEW WORKSHEET
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Disapproved	Conclusion Date: 05/29/1981
	Date Received in OIRA: 04/23/1981
Terms of Clearance: This request is disapproved. Implementation of the Pension verfication program would not be advisable at this time due to the the ambiguous and uninterpretable results of the pretest and VA's failure to perform a field test of the verification instrument. In the event that the VA wishes to resubmit the instrument for clearence the following actions should take place prior to resubmission: 1) another pre-test must be submitted for OMB review that avoids the flaws of the first pre-test, 2) the pre-test should be preformed under the conditions set forth in OMB's approval of the first pre-test on November 11, 1979, 3) a field test should be preformed prior to full scale implementation and 4) the burden per interviewer should be reduced substantially from the present level of 4-1/2 hours.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		10/24/1980
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: TO CONTINUOUSLY VERIFY BENEFIT ENTITLEMENT AND PAYMENT UNDER THE VETERANS ADMINISTRATION PENSION PROGRAM. THE PROGRAM WILL MONITOR BOTH THE SELF-REPORTING SYSTEM OF THE PENSIONERS AND THE VA'S INCOME QUESTIONNAIRE PROCESSING. THE FINDINGS WILL BE USED TO IDENTIFY AND CORRECT DEFECTS IN THE SYSTEM.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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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

IC Title	Form No.	Form Name
PENSION VERIFICATION-INTERVIEW WORKSHEET	20-8849,, 8849A,, 8849B,, 8849C,, & 21-8848

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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: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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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: 04/23/1981

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