Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant (VA Form 26-4555)

ICR 202102-2900-012

OMB: 2900-0132

Federal Form Document

ICR Details
2900-0132 202102-2900-012
Received in OIRA 201802-2900-009
VA VBA-LGY-YA
Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant (VA Form 26-4555)
Extension without change of a currently approved collection   No
Regular 04/27/2021
  Requested Previously Approved
36 Months From Approved 09/30/2021
2,000 7,000
500 1,167
0 0

VA Form 26-4555 is used to gather information necessary to determine the eligibility for the veteran or servicemember for specially adapted housing or for a special home adaptation grant.

US Code: 38 USC 2101 Name of Law: Veterans Eligible For Assistance
  
None

Not associated with rulemaking

  86 FR 10006 02/17/2021
86 FR 22301 04/27/2021
No

  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 2,000 7,000 0 -5,000 0 0
Annual Time Burden (Hours) 500 1,167 0 -667 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
Estimated 2,000 SAH applications are submitted annually at 15 minutes burden time per application. Total annual burden time is estimated at 500 hours.

$18,020
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.
04/27/2021


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