Financial Status Report

ICR 201911-2900-007

OMB: 2900-0165

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2020-05-29
Supplementary Document
2020-05-29
Supplementary Document
2020-01-27
Supporting Statement A
2020-05-29
IC Document Collections
IC ID
Document
Title
Status
44123 Modified
ICR Details
2900-0165 201911-2900-007
Active 201501-2900-004
VA 2900-0165
Financial Status Report
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 10/09/2020
Retrieve Notice of Action (NOA) 06/02/2020
OMB notes that to the extent this form is used by overpayment or debt related to current federal employees arising from their federal employment, that use is not covered by the Paperwork Reduction Act. If VA has appropriate data, it should decrease its burden estimates for that category of use in the next revision, extension, or reinstatement request.
  Inventory as of this Action Requested Previously Approved
10/31/2023 36 Months From Approved
116,151 0 0
116,151 0 0
0 0 0

Information reported on this form is necessary to evaluate eligibility for waiver of collection, payment plans or compromises and to determine hardship imposed by an offset schedule as required under 32 USC 3711, 3716 and 5 USC 5514.

US Code: 38 USC 3717 Name of Law: Interest and penalty on claims
   US Code: 38 USC 3718 Name of Law: Contracts for collection services
   US Code: 38 USC 5316 Name of Law: Authority to sue to collect certain debts
   US Code: 5 USC 5514 Name of Law: Installment deduction for indebtedness to the United States
   US Code: 38 USC 5302 Name of Law: Waiver of recovery of claims by the United States
   US Code: 38 USC 5314 Name of Law: Indebtedness offsets
   US Code: 31 USC 3711 Name of Law: Collection and compromise
   US Code: 38 USC 3716 Name of Law: Administrative offset
  
None

Not associated with rulemaking

  85 FR 1913 02/03/2020
85 FR 21511 04/17/2020
No

1
IC Title Form No. Form Name
Financial Status Report 5655 Financial Status Report

  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 116,151 0 0 20,581 0 95,570
Annual Time Burden (Hours) 116,151 0 0 20,581 0 95,570
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
More Veterans are using the form to request waiver of collection, setup a payment plan or for the acceptance of a compromise offer on their VA benefit debt.

$668,794
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.
06/02/2020


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