2900-0500SupportState

Supporting Statement for VA Form 21-0538

Status of Dependents Questionnaire

(2900-0500)

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 C.F.R. 3.652 provides that veterans are required to certify entitlement factors when requested, so VA can determine continued entitlement to the benefits being paid. Statutory authority is found in 38 U.S.C. 501, Veteran’s Benefits.

2. VA Form 21-0538 is used to request certification of the status of dependents for whom additional compensation is being paid to veterans. Without the information, continued entitlement to the benefits for dependents could not be determined.

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. VA Form 21-0538 is partially completed by VA with veteran-specific information before it is mailed to certain veterans. Veterans who are receiving compensation with additional compensation for dependents are sent this form approximately once every eight years. To avoid improper use by veterans who are not required to submit this form or are not due to submit the form, the form is not available on the VBA website for downloading. A faxed copy of a properly signed VA Form 21-0538 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.

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 determining continued eligibility for benefits for dependents. Benefits would not be properly paid, and overpayments could result.

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 July 31, 2013, page 46422. No outside consultations were solicited as no major changes are being made to the form. Regional office staff members record complaints and data for an ongoing form improvement program. No comments were received.

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 “Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28),” published at 74 FR 29275 on June 19, 2009, and last amended at 77 FR 42593 (July 19, 2012).

11. There are no questions of a sensitive nature.

12. Estimate of Information Collection Burden.

a. Number of Respondents is estimated at 84,500 per year.

b. Frequency of Response is approximately once every eight years for most beneficiaries.

c. Annual burden is 14,083 hours.

d. The estimated completion time of 10 minutes is based on review by staff personnel and previous usage of this form.

e. According to the U.S. Bureau of Labor Statistics Average Hourly Earnings, the cost to the respondent is $24, making the total estimated cost to the respondents an estimated $337,992 (14,083 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 $2,137,158

(GS-9/5 @ $28.04 x 84,500 x 55/60 minutes = $1,936,458)

(GS-5/5 @ $17.96 x 84,500 x 5/60 minutes = $ 116,187)

(GS-3/5 @ $14.73 x 84,500 x 20/60 minutes = $ 84,513)

b. Printing and production cost $7,605

c. Total cost to government $2,144,763

15. There is no change in the reporting burden. The form has been updated with the expiration date placeholder.

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.