Award Attachment for Certain Children with Disabilities Born of Vietnam and Certain Korea Service Veterans (VA Form 21-0307)

Forms and Documents

Document Name	Status
Form VA Form 21-0307 Award Attachment for Certain Children with Disabilities Born of Vietnam and Certain Korea Service Veterans Form	Modified
2015-26656, 30-Day FRN, (2900-0577).pdf Supplementary Document	2015-11-18
2900-0577SuppStmt.docx Supporting Statement A	2015-09-25
60-Day FRN (2900-0577)(7-24-15).pdf Supplementary Document	2015-07-28

IC Document Collections

IC ID	Document Title	Status
28787	Award Attachment for Certain Children with Disabilities Born of Vietnam and Certain Korea Service Veterans Form	Modified

ICR Details

OMB Control No: 2900-0577	ICR Reference No: 201506-2900-006
Status: Historical Active	Previous ICR Reference No: 201209-2900-015
Agency/Subagency: VA	Agency Tracking No: VBA-COMP-NK
Title: Award Attachment for Certain Children with Disabilities Born of Vietnam and Certain Korea Service Veterans (VA Form 21-0307)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/05/2016
	Date Received in OIRA: 11/25/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2019	36 Months From Approved	02/29/2016
Responses	75	0	75
Time Burden (Hours)	19	0	19
Cost Burden (Dollars)	0	0	0

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Abstract: VA Form 21-0307 is used to provide children who have spina bifida and are awarded VA benefits with information regarding entitlement to vocational training, health care, and payment of benefits.

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Authorizing Statute(s): US Code: 38 USC 1805 Name of Law: Monetary allowance
   US Code: 38 USC 1804 Name of Law: Vocational training and rehabilitation
   US Code: 38 USC 1815 Name of Law: Monetary allowance
   US Code: 38 USC 1803 Name of Law: Health care
  

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:
	80 FR 44198	07/24/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 63877	10/21/2015
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
Award Attachment for Certain Children with Disabilities Born of Vietnam and Certain Korea Service Veterans	VA Form 21-0307	Award Attachment for Certain Children with Disabilities Born of Vietnam and Certain Korea Service Veterans

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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	75	75	0	0	0	0
Annual Time Burden (Hours)	19	19	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: $538

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:  Yes

Description/Changes for Common Form Usage:  Adding expiration date to form.

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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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: 11/25/2015

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