Request for Contact Information

ICR 201103-2900-010

OMB: 2900-0660

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2011-06-15
IC Document Collections
IC ID
Document
Title
Status
28938 Modified
ICR Details
2900-0660 201103-2900-010
Historical Active 200709-2900-019
VA 2900-0660
Request for Contact Information
Extension without change of a currently approved collection   No
Regular
Approved without change 09/05/2011
Retrieve Notice of Action (NOA) 07/18/2011
  Inventory as of this Action Requested Previously Approved
09/30/2014 36 Months From Approved 09/30/2011
5,000 0 5,000
1,250 0 1,250
0 0 0

VA Form Letter 21-30 is used to locate individuals when a field examination is necessary to maintain program integrity. The form is used when contact information cannot be obtained by other means and travel funds may be significantly impacted. Without this information, VA could not effectively administer its benefit programs, and misuse of funds and fraud could continue.

US Code: 38 USC 5711 Name of Law: Authority to issue subpoenas
   US Code: 38 USC 5502 Name of Law: Payments to and supervision of fiduciaries
  
None

Not associated with rulemaking

  76 FR 58 03/25/2011
76 FR 109 06/07/2011
No

1
IC Title Form No. Form Name
Request for Contact Information FL 21-30 Request for Contact Information

  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 5,000 5,000 0 0 0 0
Annual Time Burden (Hours) 1,250 1,250 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$23,066
No
No
No
No
No
Uncollected
Denise McLamb 202-565-8374 denise.mclamb@mail.va.gov

  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:
 
 
 
 
 
 
 
    (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.
07/18/2011


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