Eligibility Verification Reports (EVRs)

ICR 201708-2900-012

OMB: 2900-0101

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2018-04-02
Supplementary Document
2018-01-19
Supporting Statement A
2018-03-19
IC Document Collections
IC ID
Document
Title
Status
28278 Modified
ICR Details
2900-0101 201708-2900-012
Active 201404-2900-008
VA VBA-P&F-NK
Eligibility Verification Reports (EVRs)
Revision of a currently approved collection   No
Regular
Approved with change 06/25/2018
Retrieve Notice of Action (NOA) 05/01/2018
VA is reminded that labor costs should not be included in the burden cost estimate. In addition, a reduction to the estimated length of time required to fill out a form, without changes that reduce/alter the data elements requested, is not a "deregulatory" action.
  Inventory as of this Action Requested Previously Approved
06/30/2021 36 Months From Approved 06/30/2018
69,000 0 219,000
34,500 0 113,075
0 0 2,713,800

The EVR forms are used to determine and verify entitlement to income-based VA benefits. The forms are tailored for the specific classes of beneficiaries of each benefit program and request information about income, net worth, dependency status and other entitlement factors. Without this information, VA would be unable to properly pay benefits.

US Code: 38 USC 1506 Name of Law: Resource reports and overpayment adjustments
   US Code: 38 USC 1315 Name of Law: Dependency and indemnity compensation to parents
  
None

Not associated with rulemaking

  83 FR 2878 01/19/2018
83 FR 13350 03/28/2018
No

1
IC Title Form No. Form Name
Eligibility Verification Reports VA Form 21P-0512S-1 (Spanish), VA Form 21P-0513-1 (Spanish), VA Form 21P-0514-1, VA Form 21P-0514-1 (Spanish), VA Form 21P-0517-1, VA Form 21P-0512V-1, VA Form 21P-0513-1, VA Form 21P-0516-1, VA Form 21P-0519C-1 (Spanish), VA Form 21P-0519S-1, VA Form 21P-0510, VA Form 21P-0510 (Spanish), VA Form 21P-0519C-1, VA Form 21P-0519S-1 (Spanish), VA Form 21P-0512S-1, VA Form 21P-0516-1 (Spanish), VA Form 21P-0517-1 (Spanish), VA Form 21P-0518-1, VA Form 21P-0518-1 (Spanish) Eligibility Verification Report Instructions ,   Eligibility Verification Report Instructions (Spanish) ,   Old Law Section 306 Eligibility Verification Report (Surviving Spouse) ,   Old Law and Section 306 Eligibility Verification Report (Surviving Spouse) ,   Old Law and 306 Eligibility Verification Report (Veteran) ,   Old Law and Section 306 Eligibility Verification Report (Children Only) ,   Old Law and Section 306 Eligibility Verification Report (Children Only) ,   DIC Eligibility Verification Report ,   DIC Parent's Eligibility Verification Report ,   Improved Pension Eligibility Verification Report (Veteran With No Children) ,   Improved Pension Eligibility Verification Report (Veteran With No Children) ,   Improved Pension Eligibility Verification Report (Veteran With Children) ,   Improved Pension Eligibility Verification Report (Veteran With Children) ,   Improved Pension Eligibility Verification Report (Surviving Spouse With No Children) ,   Improved Pension Eligibility Verification Report (Surviving Spouse With No Children) ,   Improved Pension Eligibility Verification Report (Child or Children) ,   Improved Pension Eligibility Verification Report (Child or Children) ,   Improved Pension Eligibility Verification Report (Surviving Spouse With Children) ,   Improved Pension Eligibility Verification Report (Surviving Spouse With Children)

  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 69,000 219,000 0 0 -150,000 0
Annual Time Burden (Hours) 34,500 113,075 0 0 -78,575 0
Annual Cost Burden (Dollars) 0 2,713,800 0 0 -2,713,800 0
No
Yes
Miscellaneous Actions
VBA conducted a program review to determine the number of forms received in a given year. VBA determined it regularly receives fewer of the forms listed in this collection than previously reported. VBA also conducted a review of the time burden of each form in this collection, and determined the average time burden to be 30 minutes for each form, which is less than the previously reported time burden for some of the forms.

$1,800,095
No
    Yes
    Yes
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.
05/01/2018


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