Application for Annual Clothing Allowance Under 38 U.S.C. 1162

Forms and Documents

Document Name	Status
Form VA Form 10-8678 Application for Annual Clothing Allowance Under 38 U.S.C. 1162 Form	Modified
10-8678-fill 2-1-12 (2).pdf Supplementary Document	2017-04-24
Request for Non-substantive change 2900-0198 VA form 10-8678_042417.doc Justification for No Material/Nonsubstantive Change	2017-04-24
201502-2900-005_VA Clothing Allowance Application Form Justification_4-20-15.docx Supporting Statement A	2015-04-20

IC Document Collections

IC ID	Document Title	Status
28438	Application for Annual Clothing Allowance Under 38 U.S.C. 1162 Form	Modified

ICR Details

OMB Control No: 2900-0198	ICR Reference No: 201605-2900-005
Status: Historical Active	Previous ICR Reference No: 201502-2900-005
Agency/Subagency: VA	Agency Tracking No: 2900-0198
Title: Application for Annual Clothing Allowance Under 38 U.S.C. 1162
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/27/2017
	Date Received in OIRA: 04/24/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2018	05/31/2018	05/31/2018
Responses	6,720	0	6,720
Time Burden (Hours)	1,120	0	1,120
Cost Burden (Dollars)	0	0	0

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Abstract: Information is requested to determine eligibility to receive a clothing allowance because 1) a prosthetic or orthopedic appliance (including a wheelchair) tends to wear out or tear clothing or 2) a prescribed medication causes irreparable damage to the outer garments.

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Authorizing Statute(s): US Code: 38 USC Part IV, Chpt. 57, Section 57 Name of Law: Confidential Nature of Claims
   US Code: 38 USC Part V, Chpt. 73, Section 7332 Name of Law: Confidentiality of Certain Medical Records
   PL: Pub.L. 107 - 247 2 Name of Law: Veterans Compensation Cost of Living Adjustment Act of 2002
   US Code: 38 USC Section 1162 Name of Law: Clothing Allowance
  

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:
	78 FR 68509	11/17/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 4334	01/27/2015
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 Annual Clothing Allowance Under 38 U.S.C. 1162	VA Form 10-8678	Application for Annual Clothing Allowance Under Title 38 U.S.C. 1162

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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	6,720	6,720	0	0	0	0
Annual Time Burden (Hours)	1,120	1,120	0	0	0	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:

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Annual Cost to Federal Government: $248,747

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: 04/24/2017

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