Notice of Waiver of VA Compensation or Pension to Receive Military Pay and Allowances

Forms and Documents

Document Name	Status
Form 21-8951-2 Notice of Waiver of VA Compensation or Pension to Receive Military Pay and Allowances Form	Modified
2900-0463 justification.docx Supporting Statement A	2011-08-25

IC Document Collections

IC ID	Document Title	Status
28659	Notice of Waiver of VA Compensation or Pension to Receive Military Pay and Allowances Form	Modified

ICR Details

OMB Control No: 2900-0463	ICR Reference No: 201104-2900-027
Status: Historical Active	Previous ICR Reference No: 200804-2900-019
Agency/Subagency: VA	Agency Tracking No: 2900-0463
Title: Notice of Waiver of VA Compensation or Pension to Receive Military Pay and Allowances
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: 01/16/2012
	Date Received in OIRA: 08/25/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2015	36 Months From Approved	01/31/2012
Responses	21,000	0	21,000
Time Burden (Hours)	3,500	0	3,500
Cost Burden (Dollars)	0	0	0

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Abstract: VA Forms 21-8951 and 21-8951-2 are used by VA beneficiaries who are also reservists/guardsmen to certify the number of days they were in training and either waive VA disability benefits in order to receive training pay or waive training pay in order to receive VA benefits. The law prohibits concurrent payment of training pay and VA benefits.

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Authorizing Statute(s): US Code: 10 USC 12316 Name of Law: Payment of Certain Reserves While on duty
   US Code: 38 USC 5304 Name of Law: Prohibition Against Duplication of Benefits
  

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:
	76 FR 91	05/11/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 141	07/22/2011
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
Notice of Waiver of VA Compensation or Pension to Receive Military Pay and Allowances	21-8951-2, 21-8951	Notice of Waiver of VA Compensation or Pension to Receive Military Pay and Allowances ,   Notice of Waiver of VA Compensation or Pension to Receive Military Pay and Allowances

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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	21,000	21,000	0	0	0	0
Annual Time Burden (Hours)	3,500	3,500	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $831,037

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]? 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? 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: 08/25/2011

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