Certificate of Delivery of Advance Payment and Enrollment

OMB Control No: 2900-0325	ICR Reference No: 201603-2900-012
Status: Historical Active	Previous ICR Reference No: 201302-2900-005
Agency/Subagency: VA	Agency Tracking No: 2900-0325 VBA-EDU-YM
Title: Certificate of Delivery of Advance Payment and Enrollment
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/04/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/22/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2016	09/30/2016	09/30/2016
Responses	700	0	700
Time Burden (Hours)	58	0	58
Cost Burden (Dollars)	0	0	0

---

Abstract: This form is used by schools to certify delivery of advance payments and to report any changes in enrollment status. VA uses the information to remove a computer control temporarily preventing future payments of benefits and to process receipt of advance payments.

---

Authorizing Statute(s): US Code: 38 USC 3034 Name of Law: Program Administration    US Code: 38 USC 3241 Name of Law: Requirements    US Code: 38 USC 3531 Name of Law: Educational Assistance Benefits    US Code: 38 USC 3680 Name of Law: Payment of educational assistance or subsistence allowances    US Code: 38 USC 3684 Name of Law: Reports by veterans, eligible persons, and institution; reporting fee    US Code: 10 USC 16136 Name of Law: Administration of Program    US Code: 10 USC 510 Name of Law: Enlistment incentives for pursuit of skills to facilitate national service    US Code: 10 USC 16166 Name of Law: Administration of Program    PL: Pub.L. 96 - 342 903 Name of Law: null

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 38	02/26/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 134	07/12/2013
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title Form No. Form Name Certificate of Delivery of Advance Payment and Enrollment 22-1999v Certificate of Delivery of Advance Payment and Enrollment

---

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	700	700	0	0	0	0
Annual Time Burden (Hours)	58	58	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:

---

Annual Cost to Federal Government: $3,849

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

Agency Contact: Crystal Rennie 202 632-7492 [email protected]

---

Common Form ICR:  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:
		(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: 03/22/2016

---