Supporting Statement for VA Form Letter 21-30
Request for Contact Information
2900-0660
A. Justification
1. The Department of Veterans Affairs (VA), through its Veterans Benefits Administration
(VBA), administers an integrated program of benefits and services established by law for veterans, service personnel, and their dependents and/or beneficiaries. 38 U.S.C. 5502 and 38 U.S.C. 5711 provide that VA has the authority to make investigations and examine witnesses upon any matter within the jurisdiction of the Department, including determining whether a fiduciary of a VA beneficiary is properly executing his/her duties. The expiration date is being added to the form.
2. VA Form Letter 21-30 is used to locate a fiduciary, beneficiary, claimant, or witness when a field examination is necessary in order to gather information that is needed to maintain program integrity. The form is used only when contact information cannot be obtained by other means, or when travel funds may be significantly impacted (e.g., when the individual resides in a remote location and has a history of not being home during the day or when visited).
3. The collection of information does not involve the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology. The information is obtained by telephone and Internet map and directory sites whenever possible. VA Form Letter 21-30 is partially completed by VA with claimant-specific information before it is mailed to certain individuals. To avoid improper use by claimants who are not required to submit this form, the form is not available on the VBA website for downloading. A faxed copy of a properly signed VA Form Letter 21-30 may be accepted if there are no questions as to its validity. Currently, there has been no consideration of using other information technology. The Department will reconsider using other information technology when the resources become available, and usage of this form increases.
4. Program reviews were conducted to identify potential areas of duplication; however, none were found to exist. There is no known Department or Agency which maintains the necessary information, nor is it available from other sources within our Department.
5. The collection of information does not involve small businesses or entities.
6. If the collection were not conducted, VA would have no means of obtaining the contact information needed to interview individuals who are difficult to locate. Without this information, VA could not effectively administer its benefit programs and misuse of funds and fraud could continue.
7. There is no special circumstance requiring collection in a manner inconsistent with
5 CFR 1320.6 guidelines.
8. The Department notice was published in the Federal Register on January 17, 2014, Volume 79, No. 12, page 3275. No comments were received received in response to this notice.
9. No payments or gifts to respondents have been made under this collection of information.
10. The records are maintained in the appropriate Privacy Act System of Records identified as 58VA21/22/28,‘‘Compensation, Pension, Education, and Rehabilitation Records—VA ’’as set forth in Privacy Act Issuances, 1993 compilation found in 74 Fed. Reg. 117 (June 19, 2009).
11. There are no questions of a sensitive nature.
12. Estimate of Information Collection Burden.
a. Number of Respondents is estimated at 5,000 per year.
b. Frequency of Response is one time for most respondents.
c. Annual burden is 1,250 burden hours.
d. The estimated completion time of 15 minutes is based on review by staff personnel.
e. According to the U.S. Bureau of Labor Statistics Average Hourly Earnings, the cost to the respondent is $24, making the total cost to the respondents an estimated $30,000. (1,250 burden hours x $24 per hour).
13. This submission does not involve any recordkeeping costs.
14. Estimated Costs to the Federal Government:
a. Processing/Analyzing costs $22,966
(GS-10/5 @ $30.88 x 5,000 x 2/60 = $5,146)
(GS-9/5 @ $28.04 x 5,000 x 5/60 = $11,683)
(GS-3/5 @ $14.73 x 5,000 x 5/60 = $6,137)
b. Printing and production cost $100
c. Total cost to government $23,066
15. There is no change in the reporting burden. The expiration date is being added to the form.
16. The information collection is not for publication or tabulation use.
17. We are not seeking approval to omit the expiration date for OMB approval.
18. This submission does not contain any exceptions to the certification statement.
B. Collection of Information Employing Statistical Methods
This collection of information does not employ statistical methods.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | SF 83 SS VAF 21-8926 |
| Author | Veterans Benefits Administrat |
| File Modified | 0000-00-00 |
| File Created | 2021-01-28 |