Application for Reimbursement of National Exam Fee (VA Form 22-0810)

Forms and Documents

Document Name	Status
Form 22-0810 Application for Reimbursement of National Exam Fee Form	Modified
2020-08133.pdf Supplementary Document	2020-10-05
2020-13441.pdf Supplementary Document	2020-10-05
Supporting Statement for VA Form 22 0810 2020.docx Supporting Statement A	2020-10-02

IC Document Collections

IC ID	Document Title	Status
181234	Application for Reimbursement of National Exam Fee Form	Modified

ICR Details

OMB Control No: 2900-0706	ICR Reference No: 202010-2900-002
Status: Active	Previous ICR Reference No: 201608-2900-004
Agency/Subagency: VA	Agency Tracking No: VBA-EDU-MS
Title: Application for Reimbursement of National Exam Fee (VA Form 22-0810)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 11/11/2020
	Date Received in OIRA: 10/05/2020
Terms of Clearance: VA is reminded to make timely submissions of extension or revision requests for ongoing collections.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2023	36 Months From Approved
Responses	297	0	0
Time Burden (Hours)	74	0	0
Cost Burden (Dollars)	154	0	0

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Abstract: Servicemembers, veterans, and eligible dependents applying for reimbursement of national exam fees will use VA Form 22-0810 to provide information necessary to process their claim.

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Authorizing Statute(s): US Code: 38 USC 3032(g((1) Name of Law: Limitations on educational assistance for certain individuals
   US Code: 10 USC 1606 Name of Law: Educational assistance for members of the selected reserve
   US Code: 10 USC 1607 Name of Law: Educational assistance for reserve component members supporting contingency operations and certain o
   US Code: 10 USC 501 Name of Law: Enlistment incentives for pursuit of skills to facilitate
   US Code: 38 USC 3232(d) Name of Law: Duration; Limitations
   US Code: 10 USC 16131 Name of Law: Educational assistance for members of the selected reserve
   US Code: 10 USC 16162 Name of Law: Educational assistance for reserve component members supporting contingency operations and certain o
   PL: Pub.L. 108 - 454 106 Name of Law: Veterans Improvement Act of 2004
   US Code: 38 USC 3532(g)(1) Name of Law: Computation of Educational Assistance Allowance
   US Code: 38 USC 5101 Name of Law: Claims and forms
  

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 8133	04/17/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 13441	06/23/2020
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 Reimbursement of National Exam Fee	22-0810	Application for Reimbursement of National Exam Fee

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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	297	0	0	87	0	210
Annual Time Burden (Hours)	74	0	0	21	0	53
Annual Cost Burden (Dollars)	154	0	0	45	0	109

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The annual burden hours have slightly increased due to an increase in individuals requesting reimbursement of national test fees.

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Annual Cost to Federal Government: $2,133

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: 10/05/2020

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