VA National Rehabilitation Special Events Forms

ICR 201304-2900-034

OMB: 2900-0759

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2014-04-14
IC Document Collections
IC ID
Document
Title
Status
193170 Modified
ICR Details
2900-0759 201304-2900-034
Historical Active 201006-2900-001
VA
VA National Rehabilitation Special Events Forms
Revision of a currently approved collection   No
Regular
Approved with change 04/21/2014
Retrieve Notice of Action (NOA) 12/30/2013
VA should consider providing an electronic option to respondents for providing information and in the next submission of this collection the Department shall report to OMB on the feasibility of an electronic option.
  Inventory as of this Action Requested Previously Approved
04/30/2017 36 Months From Approved 04/30/2014
7,688 0 3,775
1,048 0 1,257
0 0 0

VA administers National Rehabilitation Special Events for veterans who are receiving care at VA medical facilities. These events are: The National Disabled Veterans Winter Sports Clinic, National Veterans Wheelchair Games, National Veterans Golden Age Games, National Veterans Creative Arts Festival, National Veterans Summer Sports Clinic and National Veterans TEE Tournament. Each event promotes the healing of body and spirit by motivating eligible veterans to reach their full potential, improve their independence, achieve a healthier lifestyle and enjoy a higher quality of life. Veterans eligible for VA medical care may apply to attend these events using event applications.

US Code: 38 USC Section 521 Name of Law: Assistance to certain rehabilitation activities
   US Code: 38 USC Section 1710 Name of Law: Eligibility for hospital, nursing home, and domiciliary care
   US Code: 38 USC Secti on 513 Name of Law: Contracts and personal services
  
None

Not associated with rulemaking

  78 FR 76412 12/17/2013
78 FR 55777 09/11/2013
No

1
IC Title Form No. Form Name
VA National Rehabilitation Special Events VA0925 (SF), 0929d, 0928c, 0929a, 0929c, 0929e, 0929f, 0928h, 0929g, 0926b, 0929b, 0925b, 0928i, 0924n, 0926j, 0925d, 0929h, 0928a, 0924t, 0926g, 0924a, 0927a, 0927c, 0927e, 0924s, 0926h, 0928j, 0926a, 0926d, 0926e, 0927f, 0924c, 0924d National Veterans Tee Tournament, Registration Check List ,   Participant Registration Form-Physical Exam, National Veterans Tee Tournament ,   Surfing Personnel Application, National Veterans Summer Sports Clinic ,   Venue Personnel Application, National Veterans Summer Sports Clinic ,   Participant Registration Application, National Veterans Creative Arts Festival ,   National Disabled Veterans Winter Sports Clinic, Registration Check List ,   Cross Country Ski Instructor Personnel Application, National Disabled Veterans Winter Sport Clinic ,   Downhill Ski Instruction Personnel Application, National Disabled Veterans Winter Sport Clinic ,   Volunteer Application, National Disabled Veterans Winter Sports Clinic ,   Waivers and Release of Liability and Other Use Release, National Veterans Golden Age Games ,   Athlete Medical Information ,   Non-Competitor Application, National Veterans Golden Age Games ,   Athlete Application, National Veterans Golden Age Games ,   General Medical Form ,   Voluntary Service Application, National Veterans Wheelchair Games ,   General Medical/Physical Exam Form, National Veterans Summer Sports Clinic ,   Volunteer Application, National Veterans Summer Sports Clinic ,   National Veterans Golden Age Games, Registration Check List ,   National Veterans Creative Arts Festival, Participant Registration Check List ,   Participant Medical Information, National Veterans Creative Arts Festival ,   National Veterans Summer Sports Clinic, Registration Check List ,   Media and News Release Questionnair, National Veterans Creative Arts Festival ,   National Veterans Golden Age Games, Non-Competitor Registration Check List ,   Participant, Companion and Volunteer Fees, National Veterans Tee Tournament ,   Volunteer Registration Application, National Veterans Tee Tournament ,   Veteran Registration Form ,   Travel Information National Veterans Creative Arts Festival ,   General Ski Information, National Disabled Veterans Winter Sport Clinic ,   General Medical/Physical Exam Form, National Disabled Veterans Winter Sport Clinic ,   Volunteer Application, National Veterans Golden Age Games ,   Family and Friends Lodging and Meals, National Veterans Creative Arts Festival ,   Participant Agreement, National Veterans Creative Arts Festival ,   Ticket Request Form for Visual and Performing Arts Participants, National Veterans Creative Arts Festival Art and Exhibit & Stage Show

  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 7,688 3,775 0 3,913 0 0
Annual Time Burden (Hours) 1,048 1,257 0 -209 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
There is an increase in the number of respondents, which changes the burden estimate. Also, the annual cost to respondents for the hour burdens increased from $15.00 per hour (2010) to $23.00 per hour (2013) as stipulated by the Bureau of Labor Statistics.

$86,720
No
No
No
No
No
Uncollected
Crystal Rennie 202 632-7492 crystal.rennie@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.
12/30/2013


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