Veteran's Application for Increased Compensation Based on Unemployability (VA Form 21-8940)

ICR 201401-2900-008

OMB: 2900-0404

Federal Form Document

IC Document Collections
ICR Details
2900-0404 201401-2900-008
Historical Active 201103-2900-004
VA 2900-0404 VBA-COMP-NK
Veteran's Application for Increased Compensation Based on Unemployability (VA Form 21-8940)
Revision of a currently approved collection   No
Regular
Approved without change 09/16/2014
Retrieve Notice of Action (NOA) 07/28/2014
  Inventory as of this Action Requested Previously Approved
09/30/2017 36 Months From Approved 09/30/2014
24,000 0 24,000
18,000 0 18,000
0 0 0

VA Form 21-8940 is used to gather information that is necessary to determine eligibility for increased compensation based on unemployability.

US Code: 38 USC 1163 Name of Law: Trial work periods and vocational rehabilitation for certain veterans with total disability ratings.
  
None

Not associated with rulemaking

  79 FR 2 01/03/2014
79 FR 114 06/13/2014
No

  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 24,000 24,000 0 0 0 0
Annual Time Burden (Hours) 18,000 18,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$1,250,340
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.
07/28/2014


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