Conflicting Interests Certification for Proprietary Schools Only (VA Form 22-1919)

ICR 201612-2900-002

OMB: 2900-0657

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2017-05-25
Supplementary Document
2017-04-07
Supporting Statement A
2017-05-08
IC Document Collections
ICR Details
2900-0657 201612-2900-002
Active 201311-2900-010
VA VBA-EDU-NK
Conflicting Interests Certification for Proprietary Schools Only (VA Form 22-1919)
Revision of a currently approved collection   No
Regular
Approved without change 11/14/2017
Retrieve Notice of Action (NOA) 07/31/2017
  Inventory as of this Action Requested Previously Approved
11/30/2020 36 Months From Approved 11/30/2017
202 0 140
34 0 23
0 0 0

VA anticipates using data from the VA Form 22-1919 to ensure that proprietary schools comply with the law, in order to prevent erroneous VA education benefit payments.

US Code: 38 USC 3683 Name of Law: Conflicting Interest
  
None

Not associated with rulemaking

  82 FR 44 03/08/2017
82 FR 94 05/17/2017
No

1
IC Title Form No. Form Name
Conflicting Interests Certification for Proprietary Schools Only VA Form 22-1919 Conflicting Interests Certification for Proprietary Schools

  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 202 140 0 62 0 0
Annual Time Burden (Hours) 34 23 0 11 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The increase in the annual reporting burden from 23 hours to 34 hours is as a result of an increase in approvals received by the SAA and/or VA.

$1,112
No
    No
    No
No
No
No
Uncollected
Cynthia Harvey - Pryor 202 461-5870 cynthia.harvey-pryor@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.
07/31/2017


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