OMB26-4555c(4-29-08)

VA FORM 26-4555c

VETERAN'S SUPPLEMENTAL APPLICATION FOR

ASSISTANCE IN ACQUIRING SPECIALLY ADAPTED HOUSING

(2900-0031)

A. JUSTIFICATION

1. Title 38, U.S.C., chapter 21, authorizes a VA program of grants for specially adapted housing for disabled veterans. Section 2101(a) of this chapter specifically outlines those determinations that must be made by VA before such grant is approved for a particular veteran. VA Form 26-4555c is used to collect information that is necessary for VA to meet the requirements of 38 U.S.C. 2101(a). (Also, see 38 CFR 36.4402(a), 36-4404(a), and 36.4405.

2. The form is used by Loan Guaranty personnel in approving the benefit available under 38 U.S.C. 2101(a). The information requested is necessary in order to determine if it is economically feasible for a veteran to reside in specially adapted housing and to compute the proper grant amount.

3. This form is available on the One VA forms website at http://www.va.gov/vaforms. VA is in the process of developing a new electronic process system that will allow the veteran to submit this form electronically. This new system is expected to be implemented in September 2008.

4. The information collected on VA Form 26-4555c is unique to VA and is not duplicated in other agencies' records or in other VA records.

5. The collection of information does not involve small businesses.

6. The information collected on this form is completed by veterans who are applying for assistance in acquiring specially adapted housing. The data furnished on this form is essential to determining grant approval under 38 U.S.C. 2101(a). The collection is generally conducted only once.

7. There are no special circumstances that require the collection to be conducted in a manner inconsistent with the guidelines in 5 CFR 1320.6.

8. The Department notice was published in the Federal Register on February 15, 2008, page 8933. Specific consultations outside the agency were not made since the form is being completed satisfactorily by the parties involved. No comments were received.

9. No payments or gifts to respondents have been made under this collection of information.

10. Loan Guaranty Home, Condominium and Manufactured Home Loan Applicant Records, Specially Adapted Housing Applicant Records, and Vendee Loan Applicant

Records - VA (55VA26) contained in the Privacy Act Issuances, 2001 Compilation.

11. There are no questions of a sensitive nature.

12. Estimate of Information Collection Burden

a. The number of respondents is estimated at 800 per year.

b. Frequency of response is generally one-time.

c. Annual burden is 200 hours.

d. The estimated response time is 15 minutes based on field station experience with applicants.

e. The total estimated cost to respondents is $3,000 (200 hours x $15 per hour).

13. This submission does not involve any recordkeeping costs.

14. Estimated Annualized Cost to the Federal Government

$ 5,078 Total estimated cost to the Government (Loan Guaranty Processing

Cost for FY 2008 (800 cases x 15 minutes x $25.39 per hour

average Loan Guaranty field salary))

15. The increase in burden hours is due to the enactment of Public Law 109-233 which enables an eligible veteran or active duty servicemember to receive up to a total of three grants.

16. Information collection is not for tabulation or publication purposes.

17. The collection instrument, VA Form 26-4555c, may be reproduced and/or stocked by the respondents and veterans service organizations. This VA form does not display an expiration date, and if required to do so it would result in unnecessary waste of existing stocks of this form. This form is submitted to OMB for approval every 3 years. As such, this date requirement would also result in an unnecessary burden on the respondents and would delay Department action on the benefit being sought. VA also seeks to minimize its cost to itself of collection, processing, and using the information by not displaying the expiration date. For the reasons stated, VA continues to seek an exemption that waives the displaying of the expiration date on VA Form 26-4555c.

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18. This submission does not contain any exceptions to the certification statement.

B. Collections of Information Employing Statistical Methods

The Veterans Benefits Administration does not collect information employing statistical methods.

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