Court Appointed Fiduciary's Account, Federal Fiduciary's Account, Account Book, Court Appointed Fiduciary's Account, Certificate of Balance on Deposit and Authorization to Disclose Financial Records

Forms and Documents

Document Name	Status
Form VA Form 21-4706 Court Appointed Fiduciary's Account (letter size), Federal Fiduciary's Account, Account Book, and Court Appointed Fiduciary's Account, Certificate of Balance on Deposit and.... Form	Modified
2900-0017 Justification.doc Supporting Statement A	2006-10-18

IC Document Collections

IC ID	Document Title	Status
28106	Court Appointed Fiduciary's Account (letter size), Federal Fiduciary's Account, Account Book, and Court Appointed Fiduciary's Account, Certificate of Balance on Deposit and.... Form	Modified

ICR Details

OMB Control No: 2900-0017	ICR Reference No: 200610-2900-008
Status: Historical Active	Previous ICR Reference No: 200310-2900-003
Agency/Subagency: VA	Agency Tracking No:
Title: Court Appointed Fiduciary's Account, Federal Fiduciary's Account, Account Book, Court Appointed Fiduciary's Account, Certificate of Balance on Deposit and Authorization to Disclose Financial Records
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/15/2006
	Date Received in OIRA: 11/06/2006
Terms of Clearance: Approved consistent with the following terms of clearance: in the next submission of this collection to OMB for review VA shall address the feasibility of providing a fully electronic process for the submission and completion of all associated forms including acceptance of electronic signatures.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2009	36 Months From Approved	12/31/2006
Responses	31,512	0	44,000
Time Burden (Hours)	29,569	0	20,250
Cost Burden (Dollars)	0	0	0

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Abstract: VA Forms 21-4706, 21-4706, 21-4706, and 21-4718 are used to gather information necessary to determine the accounting of the veteran's compensation or pension funds spent and/or saved by his fiduciary appointment. VA Form 21-4718 a is used to gather information from the veteran's financial institution records. Without this information, VA would be unable to determine if the veteran's fiduciary is properly using the funds for this benefit according to VA law.

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Authorizing Statute(s): PL: Pub.L. 108 - 454 502-504 Name of Law: Veterans Benefits Improvement Act of 2004
   US Code: 38 USC 5502 Name of Law: Payments to and supervision of fiduciaries
  

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:
	71 FR 96	05/18/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 194	10/06/2006
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
Court Appointed Fiduciary's Account (letter size), Federal Fiduciary's Account, Account Book, and Court Appointed Fiduciary's Account, Certificate of Balance on Deposit and....	VA Form 21-4706, VA Form 21-4706c, VA Form 21-4706b, VA Form 21-4718, VA Form 21-4718a	Annual-Final Report and Accounting ,   Court Appointed Fiduciary's Acount ,   Federal Fiduciary's Account ,   Account Book ,   Certification of Balance on Deposit and Authorization to Disclose Financial Records

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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	31,512	44,000	0	-12,488	0	0
Annual Time Burden (Hours)	29,569	20,250	0	9,319	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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 change in reporting burden is due a change in law that requires VA to collect an increase amount of accounting records from veteran’s fiduciaries.

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Annual Cost to Federal Government: $472,680

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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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: 11/06/2006

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