THIS FORM IS USED BY THE VETERANS WHO
HAVE RECEIVED SPECIALLY ADAPTED HOUSING GRANTS TO PROVIDE
INFORMATION UPON WHICH INSURANCE PREMIUMS CAN BE DETERMINED, OR TO
DECLINE THE INSURANCE. THE INFORMATION ON TH FORM IS REQUIRED BY
LAW, 38 U.S.C., SECTION 806 AND 38 C.F.R. 8A.3(E). THIS SECTION OF
THE CODE PROVIDES THAT INFORMATION REQUESTED IS REQUIRED TO OBTAIN
THE INSURANCE.
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:
(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;
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.