OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion (26-0967) and Scoring Criteria for SAH Assistive Technology Grant (26-0967a)

ICR 201507-2900-006 · OMB 2900-0821 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form VA Form 26-0967 Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion and Scoring Criteria for SAH Assistive Technology Grants Form New Repair queued
2900-0967 and 0967a SupportStatement.doc Supporting Statement A Uploaded 2015-10-27 Available
IC Document Collections
IC IDCollectionTypeStatusForm
217632 Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion and Scoring Criteria for SAH Assistive Technology Grants Form New
ICR Details
2900-0821 201507-2900-006
Historical Active 201406-2900-003
VA VBA-LGY-NK
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion (26-0967) and Scoring Criteria for SAH Assistive Technology Grant (26-0967a)
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/31/2015
Retrieve Notice of Action (NOA) 10/27/2015
  Inventory as of this Action Requested Previously Approved
12/31/2018 36 Months From Approved
20 0 0
40 0 0
0 0 0
38 U.S.C. 2108 states that a person or entity seeking an SAH technology grant shall submit an application for the grant in such form and manner as the Secretary shall specify. VA is publishing proposed regulations to outline the process, the criteria, and the priorities relating to the award of these research and development grants. The proposed regulations would require applicants to submit VA Form 26-0967, Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion and VA Form 26-0967a, Specially Adaptive Housing Assistive Technology Grants Criteria and Responses.
PL: Pub.L. 111 - 275 203 Name of Law: Veterans Benefits Act of 2010
  
None
2900-AO70 Final or interim final rulemaking 80 FR 55763 09/17/2015
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 20 0 0 20 0 0
Annual Time Burden (Hours) 40 0 0 40 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new information collection. There is an "increase in burden" because we adjusted the numbers from minutes to hours to be consistent throughout the request.
$1,934
No
No
No
No
No
Uncollected
Crystal Rennie 202 632-7492 [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.
10/27/2015