Pay Now Enter Info Page

Forms and Documents

Document Name	Status
2900-0663 (5.20.14).docx Supporting Statement A	2014-05-20

IC Document Collections

IC ID	Document Title	Status
28941	Pay Now Enter Info Page Other-Internet	Modified

ICR Details

OMB Control No: 2900-0663	ICR Reference No: 201404-2900-022
Status: Historical Active	Previous ICR Reference No: 201010-2900-010
Agency/Subagency: VA	Agency Tracking No: 2900-0663
Title: Pay Now Enter Info Page
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/25/2014
	Date Received in OIRA: 05/20/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2017	36 Months From Approved	07/31/2014
Responses	148,000	0	70,000
Time Burden (Hours)	24,667	0	11,667
Cost Burden (Dollars)	0	0	0

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Abstract: Information requested on this form is used to initiate voluntary online payments from persons owing debts as a result of participation in VA benefit programs. The data is stored on a VA Web server and is used later in the transaction to associate an online payment with an indebtedness account.

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Authorizing Statute(s): US Code: 31 USC 3711 Name of Law: Collection and compromise
   US Code: 38 USC 501 Name of Law: Rules and regulations
   US Code: 38 USC 5314 Name of Law: Indebtedness offsets
   PL: Pub.L. 107 - 347 101 Name of Law: Management and promotion of electronic government services
  

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:
	79 FR 5529	01/31/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 28801	05/19/2014
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
Pay Now Enter Info Page

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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	148,000	70,000	0	78,000	0	0
Annual Time Burden (Hours)	24,667	11,667	0	13,000	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 burden hour is a result of the increase in number of respondents.

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Annual Cost to Federal Government:

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: 05/20/2014

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