Application for Burial Benefits (Under 38 U.S.C. Chapter 23) (VA Form 21P-530EZ)

Forms and Documents

Document Name	Status
Form 21P-530EZ Application for Burial Benefits (Under 38 U.S.C. Chapter 23) (VA Form 21P-530EZ) Form	Modified
2900-0003 Supporting Statement.docx Supporting Statement A	2020-05-27
30-Day FRN - 2900-0003 (2020).pdf Supplementary Document	2020-05-27
60-Day FRN -2900-0003 (2020).pdf Supplementary Document	2020-03-23

IC Document Collections

IC ID	Document Title	Status
28070	Application for Burial Benefits (Under 38 U.S.C. Chapter 23) (VA Form 21P-530EZ) Form	Modified

ICR Details

OMB Control No: 2900-0003	ICR Reference No: 201907-2900-002
Status: Active	Previous ICR Reference No: 201605-2900-002
Agency/Subagency: VA	Agency Tracking No: VBA-P&F-YA
Title: Application for Burial Benefits (Under 38 U.S.C. Chapter 23) (VA Form 21P-530EZ)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/09/2020
	Date Received in OIRA: 06/09/2020
Terms of Clearance: VA shall comply with 38 USC 5126 in processing this form. VA is also reminded that it may not conduct or sponsor a collection that does not display a valid OMB control number and that failure to maintain OMB approval is a complete statutory bar against discretionary adverse action by VA.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2023	36 Months From Approved
Responses	2,075	0	0
Time Burden (Hours)	1,038	0	0
Cost Burden (Dollars)	53,369	0	0

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Abstract: The Department of Veterans Affairs (VA), through its Veterans Benefits Administration (VBA), administers an integrated program of benefits and services established by law for veterans, service personnel, and their dependents and/or beneficiaries. Information is requested by this form under the authority of 38 U.S.C. Chapter 23 “Burial Benefits,” including 38 U.S.C. §2302, §2303, §2304, §2307, and §2308. VA uses the information provided on the form to evaluate the respondent’s eligibility for monetary burial benefits, including the burial allowance, plot or internment allowance, and transportation reimbursement. Program office was in discussions on use of form and change in format and no decision was made which is why form expired; however, decision was made to continue usage with changes.

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Authorizing Statute(s): US Code: 38 USC 2302 Name of Law: Funeral expenses
   US Code: 38 USC 2303 Name of Law: Death in Department facility; plot allowance
   US Code: 38 USC 2304 Name of Law: Claims for Reimbursement
   US Code: 38 USC 2307 Name of Law: Death from service-connected disability
   US Code: 38 USC 2308 Name of Law: Transportation of deceased Veteran to a national cemetery
  

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:
	85 FR 15039	03/16/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 31853	05/27/2020
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 Burial Benefits (Under 38 U.S.C. Chapter 23) (VA Form 21P-530EZ)	21P-530EZ	Application for Burial Benefits

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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	2,075	0	0	-132,925	0	135,000
Annual Time Burden (Hours)	1,038	0	0	-32,712	0	33,750
Annual Cost Burden (Dollars)	53,369	0	0	-648,631	0	702,000

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: Yes

Burden Reduction Due to: Using Information Technology

Short Statement: The respondent burden hour change has increased since the last submission due to the format change of the application form. Additional instructions were added to assist claimants in understanding the available burial benefits and VBA expanded the fully developed claims (FDC) process to include burial benefits. This required adding additional instructions. The FDC program is currently available to compensation service and pension original claims, and now burial benefits, which allows a claimant the opportunity to expedite claims processing when selected. However, the overall program burden has reduced because the number only reflects the number of burials processed with a form.

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Annual Cost to Federal Government: $58,772

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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? No

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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: 06/09/2020

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