Application for Work Study Allowance; Student Work-Study Agreement (Advance Payment); Extended Student Work-Study Agreement; Student Work-Study Agreement (22-8691, 22-8692, 22-8692a, & 22-8692b)

Forms and Documents

Document Name	Status
Form 22-8691 Application for Work-Study Allowance, Student Work-Study Agreement (Advance Payment), Extended Student Work-Study Agreement, Student Work-Study Agreement Form	Modified
30 Day Federal Register Due 11 13 17.docx Supplementary Document	2017-10-11
Supporting Statement 2900 0209 11 14 17.docx Supporting Statement A	2017-11-14

IC Document Collections

IC ID	Document Title	Status
28453	Application for Work-Study Allowance, Student Work-Study Agreement (Advance Payment), Extended Student Work-Study Agreement, Student Work-Study Agreement Form	Modified

ICR Details

OMB Control No: 2900-0209	ICR Reference No: 201706-2900-006
Status: Active	Previous ICR Reference No: 201409-2900-009
Agency/Subagency: VA	Agency Tracking No: VBA-EDU-YA
Title: Application for Work Study Allowance; Student Work-Study Agreement (Advance Payment); Extended Student Work-Study Agreement; Student Work-Study Agreement (22-8691, 22-8692, 22-8692a, & 22-8692b)
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: 01/31/2018
	Date Received in OIRA: 11/16/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2021	36 Months From Approved	03/31/2018
Responses	38,635	0	38,635
Time Burden (Hours)	6,457	0	6,457
Cost Burden (Dollars)	0	0	0

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Abstract: Veterans, Reservists, and other beneficiaries submit these forms to VA to apply for a work-study allowance under 38 U.S.C. chapters 30, 31, 32, 33, and 35. Section 3485 of title 38, United States Code, and section 21.4145 of title 38, Code of Federal Regulations necessitate these collections of information.

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Authorizing Statute(s): US Code: 38 USC 3104 Name of Law: chapter 31 Scope of services and assistance
   US Code: 38 USC 3485 Name of Law: Work-Study Allowance
   PL: Pub.L. 110 - 252 5003 Name of Law: Post-9/11 Veterans Educational Assistance Act of 2008 (chapter 33)
   US Code: 10 USC 16136 Name of Law: chapter 1606 Administration
   PL: Pub.L. 96 - 342 903 Name of Law: Department of Defense Authorization Act, 1981
   US Code: 10 USC 16166 Name of Law: chapter 1607 Administration
   PL: Pub.L. 107 - 314 531 Name of Law: Bob Stump National Defense Authorization Act for FY 2003
   US Code: 38 USC 3241 Name of Law: chapter 32 Administration
   US Code: 38 USC 3034(a) Name of Law: chapter 30 Administration
   US Code: 38 USC 3537 Name of Law: chapter 35 Administration
  

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:
	82 FR 35876	08/01/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 47324	10/11/2017
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
Application for Work-Study Allowance, Student Work-Study Agreement (Advance Payment), Extended Student Work-Study Agreement, Student Work-Study Agreement	22-8691, 22-8692, 22-8692a, 22-8692b	APPLICATION FOR WORK-STUDY ALLOWANCE ,   STUDENT WORK-STUDY AGREEMENT (ADVANCE PAYMENT) ,   EXTENDED STUDENT WORK-STUDY AGREEMENT ,   STUDENT WORK-STUDY AGREEMENT

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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	38,635	38,635	0	0	0	0
Annual Time Burden (Hours)	6,457	6,457	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: $136,368

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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: 11/16/2017

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