Application for Refund of Educational Contributions

Forms and Documents

Document Name	Status
Form VA Form 22-5281 Application for Refund of Educational Contributions Form	Modified
VA Form 5281.doc Supporting Statement A	2007-11-08

IC Document Collections

IC ID	Document Title	Status
28505	Application for Refund of Educational Contributions Form	Modified

ICR Details

OMB Control No: 2900-0261	ICR Reference No: 200706-2900-024
Status: Historical Active	Previous ICR Reference No: 200503-2900-003
Agency/Subagency: VA	Agency Tracking No: 2900-0261
Title: Application for Refund of Educational Contributions
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/02/2008
	Date Received in OIRA: 11/08/2007
Terms of Clearance: Consistent with the prior terms of clearance, VA shall continue to work toward providing a fully electronic process for the submission of associated information.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2011	36 Months From Approved	05/31/2008
Responses	5,000	0	50,000
Time Burden (Hours)	833	0	8,333
Cost Burden (Dollars)	0	0	0

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Abstract: Information submitted on this form is necessary in order to process the payment of refunds of contributions made by program participants who wish to disenroll.

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Authorizing Statute(s): PL: Pub.L. 94 - 502 1623 Name of Law: Refunds of contributions upon disenrollment
   US Code: 38 USC 3223 Name of Law: Refunds of contributions upon disenrollment
   PL: Pub.L. 104 - 275 3018C Name of Law: Enrollment of certain VEAP participants in Montgomery GI Bill
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 152	08/08/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 199	10/16/2007
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Application for Refund of Educational Contributions	VA Form 22-5281	Application for Refund of Educational Contributions

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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	5,000	50,000	0	0	-45,000	0
Annual Time Burden (Hours)	833	8,333	0	0	-7,500	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: The number of expected claims is substantially less than past submissions. This is partly due to the slow down of the number of individuals requesting refunds from the program for the past three years and because the program is no longer available for additional enrollees. The number of estimated responses in past submittals appears to be more than would actually be required.

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Annual Cost to Federal Government: $14,375

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]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 11/08/2007

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