Request for Change of Program or Place of Training Survivors' and Dependents' Education Assistance (Under Provisions of Chapter 35, Title 38 U.S.C.)

Forms and Documents

Document Name	Status
Form 22-5495 Request for Change of Program or Place of Training Survivors' and Dependents' Education Assistance (Under Provisions of Chapter 35, Title 38 U.S.C.) Form	Modified
5495SS Nov 2006 version.DOC Supporting Statement A	2007-07-25

IC Document Collections

IC ID	Document Title	Status
28273	Request for Change of Program or Place of Training Survivors' and Dependents' Education Assistance (Under Provisions of Chapter 35, Title 38 U.S.C.) Form	Modified

ICR Details

OMB Control No: 2900-0099	ICR Reference No: 200707-2900-043
Status: Historical Active	Previous ICR Reference No: 200407-2900-005
Agency/Subagency: VA	Agency Tracking No: 2900-0099
Title: Request for Change of Program or Place of Training Survivors' and Dependents' Education Assistance (Under Provisions of Chapter 35, Title 38 U.S.C.)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/12/2007
	Date Received in OIRA: 08/07/2007
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2010	36 Months From Approved	10/31/2007
Responses	38,418	0	17,600
Time Burden (Hours)	12,646	0	4,400
Cost Burden (Dollars)	0	0	0

---

Abstract: Surviving spouses, spouses, and children of veterans send VA this form to apply for a change of their program of education and/or a new place of training under 38 U.S.C. chapter 35. VA uses the information on the form to determine the current eligibility of the claimant for educational assistance for the new program of education or new place of training.

---

Authorizing Statute(s): US Code: 38 USC 3521 Name of Law: Approval of Application
   US Code: 38 USC 3691 Name of Law: Change of Program
   US Code: 38 USC 3513 Name of Law: Application
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 62	04/02/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 129	07/06/2007
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Request for Change of Program or Place of Training Survivors' and Dependents' Education Assistance (Under Provisions of Chapter 35, Title 38 U.S.C.)	22-5495	Request for Change of Program or Place of Training Under the Survivors' and Dependents' Educational Assistance Program

---

ICR Summary 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	38,418	17,600	0	0	20,818	0
Annual Time Burden (Hours)	12,646	4,400	0	0	8,246	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: The burden has increased because the total number of potential chapter 35 trainees has increased.

---

Annual Cost to Federal Government: $298,076

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

---

Common Form ICR:  No

---

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: 08/07/2007

---