Application for Standard Government Headstone or Marker for Installation in Private or State Veterans Cemetery

Forms and Documents

Document Name	Status
Form 40-1330 Application for Standard Government Headstone or Marker for Installation in Private or State Veterans Cemetery Form and Instruction	Modified
2900-0222 justification.doc Supporting Statement A	2010-06-14

IC Document Collections

IC ID	Document Title	Status
28470	Application for Standard Government Headstone or Marker for Installation in Private or State Veterans Cemetery Form and Instruction	Modified

ICR Details

OMB Control No: 2900-0222	ICR Reference No: 201003-2900-012
Status: Historical Active	Previous ICR Reference No: 200706-2900-030
Agency/Subagency: VA	Agency Tracking No: 2900-0222
Title: Application for Standard Government Headstone or Marker for Installation in Private or State Veterans Cemetery
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: 12/08/2010
	Date Received in OIRA: 07/13/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2013	36 Months From Approved	12/31/2010
Responses	374,000	0	334,000
Time Burden (Hours)	93,500	0	83,500
Cost Burden (Dollars)	0	0	0

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Abstract: Information is used to apply for a government provided headstone/marker for unmarked graves of eligible veterans and dependents.

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Authorizing Statute(s): PL: Pub.L. 107 - 103 501 and 502 Name of Law: Government Markers for Marked Graves at Private Cemeteries
   US Code: 38 USC Section 2306 Name of Law: Headstones, markers, and burial receptacles
   PL: Pub.L. 110 - 157 201 Name of Law: . James Allen Veteran Vision Equity Act of 2007
  

Citations for New Statutory Requirements: PL: Pub.L. 110 - 157 201 Name of Law: Blinded Veterans Paired Organs Act of 2007

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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:
	75 FR 59	03/29/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 109	06/08/2010
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
Application for Standard Government Headstone or Marker for Installation in Private or State Veterans Cemetery	VA Form 40-1330M, 40-1330	Application for Standard Headstone or Marker for Installation in a Private or State Veterans' Cemetery ,   Claim for government Medallion for Installation in a Private Cemetery

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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	374,000	334,000	40,000	0	0	0
Annual Time Burden (Hours)	93,500	83,500	10,000	0	0	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 program change is due the inclusion of VA Form 40-1330m. On December 26, 2007, the President signed the Blinded Veterans Paired Organs Act of 2007. Section 201 of Public Law 110-157 mandates the VA to provide a Government medallion to be affixed to the privately purchased headstone or a marker of a deceased eligible veteran buried in a private cemetery, which is in lieu of a Government-furnished headstone or marker

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Annual Cost to Federal Government: $38,823,000

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]? 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? 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: 07/13/2010

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