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State Cemetery Data Sheet and Cemetery Grant Documents
State Cemetery Data Sheet and Cemetery Grant Documents
OMB: 2900-0559
IC ID: 28741
OMB.report
VA
OMB 2900-0559
ICR 201602-2900-002
IC 28741
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0559 can be found here:
2023-09-14 - Revision of a currently approved collection
2020-05-20 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form VA Form 40-0895-9
State Cemetery Data Sheet and Cemetery Grant Documents
Form
40-0241 State Cemetery Data
VA40-0241 2017.pdf
www.forms.va.gov/va/Internet/VARF/getformsharness.asp?formname=40-0241-form
Form and Instruction
VA 40-0895-10 Certification of Compliance
VA40-0895-10 2017.pdf
Form
VA 40-0895-16 State or Tribal Government Cemetery Plan Preparation
VA40-0895-16 2017.pdf
Form
VA Form 40-0895-8 Certification Regarding Drug-Free Workplace
VA40-0895-8 2017.pdf
Form
VA Form 40-0895-17 State or Tribal Government Cemetery Documentation of Gra
VA40-0895-17 2017.pdf
Form
VA Form 40-0895-9 Certification Regarding Lobbying
VA40-0895-9 2017.pdf
Form
VA Form 40-0895-12 Certification Regarding Debarment, Suspension, Ineligibi
VA40-0895-12 2017.pdf
Form
VA Form 40-0895-2 Certification with Provisions of the Davis-Bacon Act
VA40-0895-2 2017.pdf
Form
VA Form 40-0895-13 Certification Regarding Documents and Information for St
VA40-0895-13 2017.pdf
Form
VA Form 40-0895-3 State or Tribal Government Cemetery Grants Service Space
VA40-0895-3 2017.pdf
Form
VA Form 40-0895-15 Certification of Cemetery Maintained in Accordance with
VA40-0895-15 2017.pdf
Form
VA Form 40-0895-6 Certification of State or Tribal Government Matching Arc
VA40-0895-6 2017.pdf
Form
VA Form 40-0895-7 Certification Regarding Debarment, Suspension and Other
VA40-0895-7 2017.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
State Cemetery Data Sheet and Cemetery Grant Documents
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
38 CFR 39
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
VA Form 40-0895-9
Certification Regarding Lobbying
VA40-0895-9 2017.pdf
No
Printable Only
Form
VA Form 40-0895-6
Certification of State or Tribal Government Matching Architectural and Engineering Funds to Qualify for Group 1 on the Priority List
VA40-0895-6 2017.pdf
No
Printable Only
Form
VA Form 40-0895-15
Certification of Cemetery Maintained in Accordance with National Cemetery Administration Standards
VA40-0895-15 2017.pdf
No
Printable Only
Form
VA Form 40-0895-8
Certification Regarding Drug-Free Workplace
VA40-0895-8 2017.pdf
No
Printable Only
Form
VA Form 40-0895-12
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion
VA40-0895-12 2017.pdf
No
Printable Only
Form
VA Form 40-0895-7
Certification Regarding Debarment, Suspension and Other Responsibility Matters Primary Covered Transactions - (State or Tribal Government)
VA40-0895-7 2017.pdf
No
Printable Only
Form
VA 40-0895-16
State or Tribal Government Cemetery Plan Preparation
VA40-0895-16 2017.pdf
No
Printable Only
Form
VA Form 40-0895-17
State or Tribal Government Cemetery Documentation of Grant Accomplishments
VA40-0895-17 2017.pdf
No
Printable Only
Form
VA Form 40-0895-3
State or Tribal Government Cemetery Grants Service Space Program Analysis - Buildings
VA40-0895-3 2017.pdf
No
Printable Only
Form and Instruction
40-0241
State Cemetery Data
VA40-0241 2017.pdf
http://www.forms.va.gov/va/Internet/VARF/getformsharness.asp?formname=40-0241-form
Yes
No
Printable Only
Form
VA 40-0895-10
Certification of Compliance
VA40-0895-10 2017.pdf
No
Printable Only
Form
VA Form 40-0895-2
Certification with Provisions of the Davis-Bacon Act
VA40-0895-2 2017.pdf
No
Printable Only
Form
VA Form 40-0895-13
Certification Regarding Documents and Information for State or Tribal Government Cemetery Construction Grants - Post Grant Requirements
VA40-0895-13 2017.pdf
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
286
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
286
0
0
-75
0
361
Annual IC Time Burden (Hours)
10,050
0
0
-4,008
0
14,058
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.