Application for Refund of Educational Contributions (VA Form 22-5281)

ICR 201909-2900-008

OMB: 2900-0261

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2019-12-16
Supporting Statement A
2019-10-23
Supplementary Document
2019-10-23
IC Document Collections
IC ID
Document
Title
Status
28505 Modified
ICR Details
2900-0261 201909-2900-008
Active 201602-2900-030
VA VBA-EDU-NK
Application for Refund of Educational Contributions (VA Form 22-5281)
Revision of a currently approved collection   No
Regular
Approved with change 09/28/2020
Retrieve Notice of Action (NOA) 01/16/2020
  Inventory as of this Action Requested Previously Approved
09/30/2023 36 Months From Approved 09/30/2020
67 0 461
11 0 77
0 0 0

The information submitted on VA Form 22-5281 is necessary in order to process the payment of refunds of contributions made by program participants who wish to dis enroll.

US Code: 38 USC 3223 Name of Law: Refunds of contributions upon disenrollment
   PL: Pub.L. 94 - 502 1623 Name of Law: Refunds of contributions upon disenrollment
   PL: Pub.L. 104 - 275 3018C Name of Law: Enrollment of certain VEAP participants in Montgomery GI Bill
  
None

Not associated with rulemaking

  84 FR 21931 10/08/2019
84 FR 26958 12/16/2019
No

1
IC Title Form No. Form Name
Application for Refund of Educational Contributions VA Form 22-5281 Application for Refund of Educational Contributions

  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 67 461 0 -394 0 0
Annual Time Burden (Hours) 11 77 0 -66 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
The decrease is due to fewer program participants.

$156
No
    Yes
    Yes
No
No
No
No
Danny Green 202 421-1354 danny.green2@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.
01/16/2020


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