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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 201802-2900-008 · OMB 2900-0821 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form VA Form 26-0967 Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion (26-0967) and Scoring Criteria for SAH Assistive Technology Grant (26-0967a) Form New Available
2018-05445 60 Day FRN 2900-0821.pdf Supplementary Document Uploaded 2018-09-26 Available
2018-13904 30 Day FRN 2900-0821.pdf Supplementary Document Uploaded 2018-09-26 Available
2018-10846.pdf Supplementary Document Uploaded 2018-06-25 Available
2018-01988 Notice of Funding Availability FRN.pdf Supplementary Document Uploaded 2018-02-09 Available
Supporting Statement(2900-0821) 92618.docx Supporting Statement A Uploaded 2018-09-26 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
230645 Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion (26-0967) and Scoring Criteria for SAH Assistive Technology Grant (26-0967a) Form New
ICR Details
2900-0821 201802-2900-008
Active 201507-2900-006
VA VBA-LGY-NK
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion (26-0967) and Scoring Criteria for SAH Assistive Technology Grant (26-0967a)
Extension without change of a currently approved collection   No
Regular
Approved without change 11/02/2018
Retrieve Notice of Action (NOA) 10/11/2018
  Inventory as of this Action Requested Previously Approved
11/30/2021 36 Months From Approved 12/31/2018
20 0 20
40 0 40
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
Not associated with rulemaking
  83 FR 10846 03/19/2018
83 FR 28492 06/28/2018
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 20 0 0 0 0
Annual Time Burden (Hours) 40 40 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$1,642
No
    Yes
    Yes
No
No
No
Uncollected
Nancy Kessinger 202 632-8924 [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.
10/11/2018