Application for Work Study Allowance; Student Work-Study Agreement (Advance Payment); Extended Student Work-Study Agreement; Student Work-Study Agreement

Forms and Documents

Document Name	Status
Form VA Form 22-8691 Application for Work-Study Allowance, Student Work-Study Agreement (Advance Payment), Extended Student Work-Study Agreement, Student Work-Study Agreement Form	Modified
2900-0209 justification.docx Supporting Statement A	2012-03-08

IC Document Collections

IC ID	Document Title	Status
28453	Application for Work-Study Allowance, Student Work-Study Agreement (Advance Payment), Extended Student Work-Study Agreement, Student Work-Study Agreement Form	Modified

ICR Details

OMB Control No: 2900-0209	ICR Reference No: 201110-2900-015
Status: Historical Active	Previous ICR Reference No: 200811-2900-003
Agency/Subagency: VA	Agency Tracking No: 2900-0209
Title: Application for Work Study Allowance; Student Work-Study Agreement (Advance Payment); Extended Student Work-Study Agreement; Student Work-Study Agreement
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/19/2012
	Date Received in OIRA: 03/08/2012
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years. The agency is reminded that all instruments, including "electronic" versions of paper forms should be submitted as part of their request for approval.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2015	36 Months From Approved	06/30/2012
Responses	33,700	0	32,500
Time Burden (Hours)	5,795	0	5,592
Cost Burden (Dollars)	0	0	0

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Abstract: Veterans, Reservists, and other beneficiaries submit these forms to VA to apply for a work-study allowance under 38 U.S.C. chapters 30, 31, 32, 33, and 35; Section 903 of Public Law 96-342; 10 U.S.C. chapters 1606 and 1607; and the National Call to Service provision of Public Law 107-314.

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Authorizing Statute(s): US Code: 10 USC 16166 Name of Law: chapter 1607 Administration
   US Code: 38 USC 3104 Name of Law: chapter 31 Scope of services and assistance
   US Code: 38 USC 3485 Name of Law: Work-Study Allowance
   PL: Pub.L. 110 - 252 5003 Name of Law: Post-9/11 Veterans Educational Assistance Act of 2008 (chapter 33)
   US Code: 10 USC 16136 Name of Law: chapter 1606 Administration
   PL: Pub.L. 96 - 342 903 Name of Law: Department of Defense Authorization Act, 1981
   PL: Pub.L. 107 - 314 531 Name of Law: Bob Stump National Defense Authorization Act for FY 2003
   US Code: 38 USC 3241 Name of Law: chapter 32 Administration
   US Code: 38 USC 3537 Name of Law: chapter 35 Administration
   US Code: 38 USC 3034(a) Name of Law: chapter 30 Administration
  

Citations for New Statutory Requirements: None

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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:
	76 FR 211	11/01/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 10	01/17/2012
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 Work-Study Allowance, Student Work-Study Agreement (Advance Payment), Extended Student Work-Study Agreement, Student Work-Study Agreement	VA Form 22-8692, VA Form 22-8692b, VA Form 22-8692a, VA Form 22-8691	Application For Work-Study Allowance ,   Student Work-Study Agreement (Advance Payment) ,   Extended Student Work-Study Agreement ,   Student Work-Study Agreement

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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	33,700	32,500	0	0	1,200	0
Annual Time Burden (Hours)	5,795	5,592	0	0	203	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 increase in the public burden hours to the current estimate of 5,795 hours (for 33,700 responses) reflects the increase in the annual projected number of applications, contracts, and extensions for FY 2012 through 2014 based on the actual number of these forms submitted for FY 2007, 2008, 2009 and 2010.

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Annual Cost to Federal Government: $122,552

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: 03/08/2012

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