2900-0031 justification

VA FORM 26-4555c

VETERAN/SERVICEMEMBER’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 or servicemembers. 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 or servicemember. 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 or servicemember to reside in specially adapted housing and to compute the proper grant amount. Page two of the April 2008 version of VA Form 26-4555C has been removed since this information is available through public records. On occasion, this information is not available, and is requested from the veteran, servicemember, or his or her agent.

3. This form is available in a fillable electronic format on the One VA forms website at http://www.va.gov/vaforms. Once a determination on eligibility is made and the file is reviewed by Loan Guaranty personnel, the veteran or servicemember is directed to complete VA Form 26-4555c with instructions. An electronic submission system would not allow for personal customer service, and would delay applications from being processed due to errors. VA will continue to explore the use of information technology to submit this form.

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 March 25, 2011 pages 16859-16860. No comments were received in response to this notice.

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 1,400 per year.

b. Frequency of response is generally one-time.

c. Annual burden is 350 hours.

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

e. The total estimated cost to respondents is $5,250 (350 hours x $15 per hour).

13. This submission does not involve any recordkeeping costs.

14. Estimated Annualized Cost to the Federal Government

$ 9,534 Total estimated cost to the Government (Loan Guaranty Processing

Cost for FY 2011 (1,400 cases x 15 minutes x $27.24 per hour

average Loan Guaranty field salary))

15. The increase in burden hours is due to the rise in the number of respondents.

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.

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.