REPS Annual Eligibility Report (Under the Provisions of Section 156, Public Law 97-377) (VA Form 21P-8941)

ICR 201708-2900-016

OMB: 2900-0405

Federal Form Document

Forms and Documents
ICR Details
2900-0405 201708-2900-016
Active 201404-2900-019
VA VBA-P&F-YA
REPS Annual Eligibility Report (Under the Provisions of Section 156, Public Law 97-377) (VA Form 21P-8941)
Extension without change of a currently approved collection   No
Regular
Approved without change 03/05/2018
Retrieve Notice of Action (NOA) 12/27/2017
  Inventory as of this Action Requested Previously Approved
03/31/2021 36 Months From Approved 03/31/2018
1,200 0 1,200
300 0 300
7,155 0 0

VA Form 21P-8941 (formerly VA Form 21-8941) is used to gather information that is necessary to determine a REPS beneficiary's continued entitlement to REPS benefits. Without this information, VA would be unable to properly authorize benefits, and overpayments would result.

US Code: 38 USC 5101 Name of Law: Claims and Forms
  
None

Not associated with rulemaking

  82 FR 45362 09/28/2017
82 FR 57817 12/07/2017
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 1,200 1,200 0 0 0 0
Annual Time Burden (Hours) 300 300 0 0 0 0
Annual Cost Burden (Dollars) 7,155 0 0 7,155 0 0
No
No

$26,460
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.
12/27/2017


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