Request for Contact Information (VA Form Letter 21-30)

ICR 202009-2900-009

OMB: 2900-0660

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2021-04-13
Supplementary Document
2021-04-13
Supplementary Document
2021-03-04
IC Document Collections
IC ID
Document
Title
Status
28938 Modified
ICR Details
2900-0660 202009-2900-009
Received in OIRA 201701-2900-003
VA VBA-COMP-NK
Request for Contact Information (VA Form Letter 21-30)
Reinstatement without change of a previously approved collection   No
Regular 04/13/2021
  Requested Previously Approved
36 Months From Approved
5,000 0
1,250 0
0 0

VA Form Letter 21-30 is used to locate individuals when a field examination is necessary to maintain program integrity. The form is used when contact information cannot be obtained by other means and travel funds may be significantly impacted. Without this information, VA could not effectively administer its benefit programs, and misuse of funds and fraud could continue.

US Code: 38 USC 5502 Name of Law: Payments to and supervision of fiduciaries
   US Code: 38 USC 5711 Name of Law: Authority to issue subpoenas
  
None

Not associated with rulemaking

  86 FR 3899 02/25/2021
86 FR 7527 04/13/2021
No

1
IC Title Form No. Form Name
Request for Contact Information (FL21P-30) VA Form FL21-30 Request for Contact Information

  Total Request 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 5,000 0 0 0 0 5,000
Annual Time Burden (Hours) 1,250 0 0 0 0 1,250
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$60,085
No
    Yes
    Yes
No
No
No
No
Maribel Aponte 202 266-4688 maribel.aponte@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.
04/13/2021


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