OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Benefits for Certain Children with Disabilities Born of Vietnam and Certain Korea Service Veterans

ICR 200702-2900-003 · OMB 2900-0572 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 21-0304 Application for Benefits for Certain Children with Disabilities Born of Vietnam and Certain Korea Service Veterans Form Modified Repair queued
2900-0572 justification.doc Supporting Statement A Uploaded 0000-00-00 Available
IC Document Collections
IC IDCollectionTypeStatusForm
28777 Application for Benefits for Certain Children with Disabilities Born of Vietnam and Certain Korea Service Veterans Form Modified
ICR Details
2900-0572 200702-2900-003
Historical Active 200403-2900-004
VA 2900-0572
Application for Benefits for Certain Children with Disabilities Born of Vietnam and Certain Korea Service Veterans
Extension without change of a currently approved collection   No
Regular
Approved without change 04/11/2007
Retrieve Notice of Action (NOA) 03/01/2007
  Inventory as of this Action Requested Previously Approved
04/30/2010 36 Months From Approved 04/30/2007
430 0 430
72 0 72
0 0 0
VA Form 21-0304 is used to gather information necessary to determine eligibility for a monetary allowance for a child born with spina bifida or certain birth defects who is a natural child of a Vietnam veteran.
US Code: 38 USC Section 1805 Name of Law: Monetary allowance
   US Code: 38 USC Section 1815 Name of Law: Monetary allowance
  
None
Not associated with rulemaking
  71 FR 162 08/22/2006
72 FR 38 02/27/2007
No
  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 430 430 0 0 0 0
Annual Time Burden (Hours) 72 72 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$19,508
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Denise McLamb 202-565-8374 [email protected]
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
03/01/2007