OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

VBA Contractor Background Investigation Request (VA Form 20-10276), VBA Affiliate Background Investigation Request (VA Form 20-10276a)

ICR 202410-2900-006 · OMB 2900-0915 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 20-10276 VBA Contractor Background Investigation Request (VA Form 20-10276), VBA Affiliate Background Investigation Request (VA Form 20-10276a) Form Modified Repair queued
30-Day FRN - 2900-0915 (2024).pdf Supplementary Document Uploaded 2024-12-23 Repair queued
60-Day FRN - 2900-0915 (2024).pdf Supplementary Document Uploaded 2024-11-19 Repair queued
2900-0915 Supporting Statement (VA Form 10276 Series).docx Supporting Statement A Uploaded 2024-12-23 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
253236 VBA Contractor Background Investigation Request (VA Form 20-10276), VBA Affiliate Background Investigation Request (VA Form 20-10276a) Form Modified
ICR Details
2900-0915 202410-2900-006
Received in OIRA 202204-2900-016
VA VBA-HCS-YA
VBA Contractor Background Investigation Request (VA Form 20-10276), VBA Affiliate Background Investigation Request (VA Form 20-10276a)
Revision of a currently approved collection   No
Regular 12/23/2024
  Requested Previously Approved
36 Months From Approved 09/30/2025
10,000 5,000
2,167 833
0 0
VA Forms 20-10276 and 20-10276a are used to gather the mandatory information to determine eligibility for employment and have physical and logical access for VBA. Without this information, determination of eligibility for employment and access would not be possible. The new form (VA Form 20-10276a) added to this collection is used to collect information from Affiliates who are applying to work/volunteer for VBA. After the collection, personnel security specialists can perform background investigation work to determine eligibility for employment and to have physical and logical access to VBA Systems.
None
None
Not associated with rulemaking
  89 FR 83953 10/18/2024
89 FR 104613 12/23/2024
No
  Total Request 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 10,000 5,000 0 5,000 0 0
Annual Time Burden (Hours) 2,167 833 0 1,334 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The burden has increased due to the addition of this new form.
$729,887
No
    Yes
    Yes
No
No
No
No
Maribel Aponte 202 266-4688 [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.
12/23/2024