On-The-Job Training Agreement (VA Form 28-1904)

ICR 202104-2900-013

OMB: 2900-0678

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2021-06-28
Supporting Statement A
2021-06-23
Supplementary Document
2021-04-22
IC Document Collections
IC ID
Document
Title
Status
28956 Modified
ICR Details
2900-0678 202104-2900-013
Received in OIRA 201403-2900-022
VA VBA-VR&E-NK
On-The-Job Training Agreement (VA Form 28-1904)
Reinstatement without change of a previously approved collection   No
Regular 06/29/2021
  Requested Previously Approved
36 Months From Approved
1,400 0
350 0
0 0

VA Form 28-1904 is used to gather the necessary information to develop formal agreements for training and rehabilitation under 38 U.S.C. Chapter 31. Additionally, the information is used to authorize a claimant’s participation in a program of training under 38 U.S.C. 501(a), 38 U.S.C. 3104 and 38 U.S.C. 3116.

US Code: 38 USC 3116 Name of Law: Promotion of employment and training opportunities
   US Code: 38 USC 3104 Name of Law: Scope of services and assistance
   US Code: 38 USC 501(a) Name of Law: Rules and regulations
  
None

Not associated with rulemaking

  86 FR 8387 04/22/2021
86 FR 13752 06/28/2021
No

1
IC Title Form No. Form Name
On-The-Job Training Agreement (VA Form 28-1904) VA Form 28-1904 On-The-Job Training Agreement

  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 1,400 0 0 800 0 600
Annual Time Burden (Hours) 350 0 0 200 0 150
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The respondent burden has increased over the past several years since there has been an increase in claimants participating in on-job training programs. This could be attributed to the increase in training opportunities within the Federal, State and Local Government based on Executive Order 13518 establishing the “Veterans Employment Initiative”.

$74,649
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.
06/29/2021


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