Reports of: General Information, First Notice of Death, Nursing Home or Assisted Living, Defense Finance & Accounting, Non-Receipt of Payment, Incarceration, Month of Death (VA Forms 27-0820 series)

ICR 201712-2900-006

OMB: 2900-0734

Federal Form Document

ICR Details
2900-0734 201712-2900-006
Active 201411-2900-005
VA VBA-BAS-NK
Reports of: General Information, First Notice of Death, Nursing Home or Assisted Living, Defense Finance & Accounting, Non-Receipt of Payment, Incarceration, Month of Death (VA Forms 27-0820 series)
Extension without change of a currently approved collection   No
Regular
Approved with change 07/23/2018
Retrieve Notice of Action (NOA) 06/01/2018
We appreciate VA's agreement to report back on the actual number of form submissions when this collection is renewed.
  Inventory as of this Action Requested Previously Approved
07/31/2021 36 Months From Approved 09/30/2018
2,550,000 0 2,550,000
212,500 0 212,500
0 0 0

These forms will be used by VA Regional Office and Pension Maintenance Center employees to meet our requirement to document verbal evidence obtained telephonically from our beneficiary or claimant that will be used as part of the evidence for a claim for benefits.

None
None

Not associated with rulemaking

  83 FR 2363 02/07/2018
83 FR 9056 04/30/2018
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 2,550,000 2,550,000 0 0 0 0
Annual Time Burden (Hours) 212,500 212,500 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$62,917,259
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.
06/01/2018


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