Agency Information Collection Activities Under OMB Review, 24864-24865 [E5-2304]
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24864
Federal Register / Vol. 70, No. 90 / Wednesday, May 11, 2005 / Notices
new collection, and allow 60 days for
public comment in response to this
notice. This notice solicits comments on
information needed to process current
and former employee’s claims for
restored annual leave charged on a
nonworkday while on military active
duty.
Written comments and
recommendations on the proposed
collection of information should be
received on or before July 11, 2005.
ADDRESSES: Submit written comments
on the collection of information to Katie
McCullough-Bradshaw, Human
Resources Management (058),
Department of Veterans Affairs, 810
Vermont Avenue, NW., Washington, DC
20420 or e-mail Katie.McCulloughBradshaw@mail.va.gov. Please refer to
‘‘OMB Control No. 2900–New’’ in any
correspondence.
DATES:
Katie McCullough-Bradshaw at (202)
273–9836 or fax (202) 275–7607.
SUPPLEMENTARY INFORMATION: Under the
PRA of 1995 (Pub. L. 104–13; 44 U.S.C.
3501–3521), Federal agencies must
obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. This request for comment is
being made pursuant to Section
3506(c)(2)(A) of the PRA.
With respect to the following
collection of information, HRM invites
comments on: (1) Whether the proposed
collection of information is necessary
for the proper performance of HRM’s
functions, including whether the
information will have practical utility;
(2) the accuracy of HRM’s estimate of
the burden of the proposed collection of
information; (3) ways to enhance the
quality, utility, and clarity of the
information to be collected; and (4)
ways to minimize the burden of the
collection of information on
respondents, including through the use
of automated collection techniques or
the use of other forms of information
technology.
Title: Claim for Credit of Annual
Leave, VA Form 0862.
OMB Control Number: 2900–New.
Type of Review: New collection.
Abstract: Current and former
employee’s who were charged annual
leave on a nonworkday while on active
military duty complete VA Form 0862
to request restoration of annual leave.
Those employees who separated or
retired from VA will receive a lump sum
payment for any reaccredited annual
leave. The claimant must provide
documentation supporting the period
that he or she were on active military
16:48 May 10, 2005
Jkt 205001
Dated: April 29, 2005.
By direction of the Secretary.
Loise Russell,
Director, Records Management Service.
[FR Doc. E5–2302 Filed 5–10–05; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0161]
FOR FURTHER INFORMATION CONTACT:
VerDate jul<14>2003
duty during the time for which they
were charged annual leave on a
nonworkday.
Affected Public: Individuals or
households and Federal Government.
Estimated Annual Burden: 3,375
hours.
Estimated Average Burden per
Respondent: 15 minutes.
Frequency of Response: One-time.
Estimated Number of Respondents:
13,501.
Agency Information Collection
Activities Under OMB Review
Veterans Benefits
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:
SUMMARY: In compliance with the
Paperwork Reduction Act (PRA) of 1995
(44 U.S.C. 3501–3521), this notice
announces that the Veterans Benefits
Administration (VBA), Department of
Veterans Affairs, has submitted the
collection of information abstracted
below to the Office of Management and
Budget (OMB) for review and comment.
The PRA submission describes the
nature of the information collection and
its expected cost and burden; it includes
the actual data collection instrument.
DATES: Comments must be submitted on
or before June 10, 2005.
FOR FURTHER INFORMATION OR A COPY OF
THE SUBMISSION CONTACT: Denise
McLamb, Records Management Service
(005E3), Department of Veterans Affairs,
810 Vermont Avenue, NW.,
Washington, DC 20420, (202) 273–8030,
fax (202) 273–5981 or e-mail:
denise.mclamb@mail.va.gov. Please
refer to ‘‘OMB Control No. 2900–0161.’’
Send comments and
recommendations concerning any
aspect of the information collection to
VA’s OMB Desk Officer, OMB Human
Resources and Housing Branch, New
Executive Office Building, Room 10235,
Washington, DC 20503 (202) 395–7316.
Please refer to ‘‘OMB Control No. 2900–
0161’’ in any correspondence.
SUPPLEMENTARY INFORMATION:
Title: Medical Expense Report, VA
Form 21–8416.
PO 00000
Frm 00100
Fmt 4703
Sfmt 4703
OMB Control Number: 2900–0161.
Type of Review: Extension of a
currently approved collection.
Abstract: VA Form 21–8416 is
completed by beneficiaries in receipt of
or claiming income-based benefits to
report medical expenses paid in
connection with claims for pension and
other income-based benefits.
Unreimbursed medical expenses paid
by a beneficiary or claimant may be
excluded from their countable income.
VA uses the data collected to determine
the claimant’s entitlement to improved
pension and the appropriate rate
payable.
An agency may not conduct or
sponsor, and a person is not required to
respond to a collection of information
unless it displays a currently valid OMB
control number. The Federal Register
notice with a 60-day comment period
soliciting comments on this collection
of information was published on
January 11, 2005, at page 1934.
Affected Public: Individuals or
households.
Estimated Annual Burden: 48,200
hours.
Estimated Average Burden per
Respondent: 30 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
96,400.
Dated: April 29, 2005.
By direction of the Secretary.
Loise Russell,
Director, Records Management Service.
[FR Doc. E5–2303 Filed 5–10–05; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0629]
Agency Information Collection
Activities Under OMB Review
Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:
SUMMARY: In compliance with the
Paperwork Reduction Act (PRA) of 1995
(44 U.S.C. 3501–21), this notice
announces that the Veterans Health
Administration (VHA), Department of
Veterans Affairs, has submitted the
collection of information abstracted
below to the Office of Management and
Budget (OMB) for review and comment.
The PRA submission describes the
nature of the information collection and
its expected cost and burden and
includes the actual data collection
instrument.
E:\FR\FM\11MYN1.SGM
11MYN1
Federal Register / Vol. 70, No. 90 / Wednesday, May 11, 2005 / Notices
DATES:
Comments must be submitted on
or before June 10, 2005.
DEPARTMENT OF VETERANS
AFFAIRS
FOR FURTHER INFORMATION OR A COPY OF
THE SUBMISSION CONTACT: Denise
[OMB Control No. 2900–0101]
McLamb, Records Management Service
(005E3), Department of Veterans Affairs,
810 Vermont Avenue, NW.,
Washington, DC 20420, (202) 273–8030,
fax (202) 273–5981 or e-mail to:
denise.mclamb@mail.va.gov. Please
refer to ‘‘OMB Control No. 2900–0629.’’
Send comments and
recommendations concerning any
aspect of the information collection to
VA’s OMB Desk Officer, OMB Human
Resources and Housing Branch, New
Executive Office Building, Room 10235,
Washington, DC 20503, (202) 395–7316.
Please refer to ‘‘OMB Control No. 2900–
0629’’ in any correspondence.
SUPPLEMENTARY INFORMATION:
Title: Application for Extended Care
Services, VA Form 10–10EC.
OMB Control Number: 2900–0629.
Type of Review: Extension of a
currently approved collection.
Abstract: VA Form 10–10EC is used to
gather current income and financial
information from nonservice-connected
veterans and their spouse when
applying for extended care services and
to establish a co-payment agreement for
such services. VA provides extended
care to non-service connected veterans
who are unable to defray the necessary
expenses of care if their income is not
greater than the maximum annual
pension rate. VA uses the data collected
to establish the veteran’s eligibility for
extended care services, financial
liability, if any, of the veteran to pay if
accepted for placement or treatment in
extended care services, and to
determine the appropriate co-payment.
An agency may not conduct or
sponsor, and a person is not required to
respond to a collection of information
unless it displays a currently valid OMB
control number. The Federal Register
notice with a 60-day comment period
soliciting comments on this collection
of information was published on
January 5, 2005, at pages 939–940.
Affected Public: Individuals or
Households.
Estimated Total Annual Burden:
9,000 hours.
Estimated Average Burden per
Respondent: 90 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
6,000.
Agency Information Collection
Activities Under OMB Review
Dated: April 29, 2005.
By direction of the Secretary.
Loise Russell,
Director, Records Management Service.
[FR Doc. E5–2304 Filed 5–10–05; 8:45 am]
BILLING CODE 8320–01–P
VerDate jul<14>2003
16:48 May 10, 2005
Jkt 205001
Veterans Benefits
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:
SUMMARY: In compliance with the
Paperwork Reduction Act (PRA) of 1995
(44 U.S.C. 3501–3521), this notice
announces that the Veterans Benefits
Administration (VBA), Department of
Veterans Affairs, has submitted the
collection of information abstracted
below to the Office of Management and
Budget (OMB) for review and comment.
The PRA submission describes the
nature of the information collection and
its expected cost and burden; it includes
the actual data collection instrument.
DATES: Comments must be submitted on
or before June 10, 2005.
FOR FURTHER INFORMATION OR A COPY OF
THE SUBMISSION CONTACT: Denise
McLamb, Records Management Service
(005E3), Department of Veterans Affairs,
810 Vermont Avenue, NW.,
Washington, DC 20420, (202) 273–8030,
FAX (202) 273–5981 or e-mail:
denise.mclamb@mail.va.gov. Please
refer to ‘‘OMB Control No. 2900–0101.’’
Send comments and
recommendations concerning any
aspect of the information collection to
VA’s OMB Desk Officer, OMB Human
Resources and Housing Branch, New
Executive Office Building, Room 10235,
Washington, DC 20503 (202) 395–7316.
Please refer to ‘‘OMB Control No. 2900–
0101’’ in any correspondence.
SUPPLEMENTARY INFORMATION:
Titles: Eligibility Verification Reports
(EVR).
a. Eligibility Verification Report
Instructions, VA Form 21–0510.
b. Old Law and Section 306 Eligibility
Verification Report (Surviving Spouse),
VA Form 21–0512S–1.
c. Old Law and Section 306 Eligibility
Verification Report (Veteran), VA Form
21–0512V–1.
d. Old Law and Section 306 Eligibility
Verification Report (Children Only), VA
Form 21–0513–1.
e. DIC Parent’s Eligibility Verification
Report, VA Forms 21–0514 and 21–
0514–1.
f. Improved Pension Eligibility
Verification Report (Veteran With No
Children), VA Forms 21–0516 and 21–
0516–1.
g. Improved Pension Eligibility
Verification Report (Veteran With
PO 00000
Frm 00101
Fmt 4703
Sfmt 4703
24865
Children), VA Forms 21–0517 and 21–
0517–1.
h. Improved Pension Eligibility
Verification Report (Surviving Spouse
With No Children), VA Forms 21–0518
and 21–0518–1.
i. Improved Pension Eligibility
Verification Report (Child or Children),
VA Forms 21–0519C and 21–0519C–1.
j. Improved Pension Eligibility
Verification Report (Surviving Spouse
With Children), VA Forms 21–0519S
and 21–0519S–1.
OMB Control Number: 2900–0101.
Type of Review: Revision of a
currently approved collection.
Abstract: VA uses Eligibility
Verification Reports (EVR) forms to
verify a claimant’s continued
entitlement to benefits. Claimants who
applied for or receives Improved
Pension or Parents’ Dependency and
Indemnity Compensation must
promptly notify VA in writing of any
changes in entitlement factors. EVRs are
required annually by beneficiaries
whose social security number (SSN) or
whose spouse’s SSN is not verified, or
who has income other than Social
Security. Recipients of Old Law and
Section 306 Pension are no longer
required to submit annual EVRs unless
there is a change in their income.
An agency may not conduct or
sponsor, and a person is not required to
respond to a collection of information
unless it displays a currently valid OMB
control number. The Federal Register
notice with a 60-day comment period
soliciting comments on this collection
of information was published on
November 12, 2004, at pages 65504–
65505.
Affected Public: Individuals or
households.
Estimated Annual Burden: 113,075
hours. The annual burden for VA Forms
21–0512S–1, 21–0512V–1, 21–0513–1,
21–0514, 21–0514–1, 21–0516, 21–
0516–1, 21–0518, 21–0518–1, 21–
0519C, and 21–0519C–1 is 9,8775 and
14,300 for VA Forms 21–0517, 21–
0517–1, 21–0519S, and 21–0519S–1.
Estimated Average Burden Per
Respondent: The estimated burden
respondent for VA Forms 21–0512S–1,
21–0512V–1, 21–0513–1, 21–0514, 21–
0514–1, 21–0516, 21–0516–1, 21–0518,
21–0518–1, 21–0519C, and 21–0519C–1
is 30 minutes and 40 minutes for VA
Forms 21–0517, 21–0517–1, 21–0519S,
and 21–0519S–1.
Frequency of Response: Annually.
Estimated Number of Respondents:
219,000. The number of respondents for
VA Forms 21–0512S–1, 21–0512V–1,
21–0513–1, 21–0514, 21–0514–1, 21–
0516, 21–0516–1, 21–0518, 21–0518–1,
21–0519C, and 21–0519C–1 is 197,550
E:\FR\FM\11MYN1.SGM
11MYN1
Agencies
[Federal Register Volume 70, Number 90 (Wednesday, May 11, 2005)]
[Notices]
[Pages 24864-24865]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E5-2304]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0629]
Agency Information Collection Activities Under OMB Review
AGENCY: Veterans Health Administration, Department of Veterans Affairs.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995
(44 U.S.C. 3501-21), this notice announces that the Veterans Health
Administration (VHA), Department of Veterans Affairs, has submitted the
collection of information abstracted below to the Office of Management
and Budget (OMB) for review and comment. The PRA submission describes
the nature of the information collection and its expected cost and
burden and includes the actual data collection instrument.
[[Page 24865]]
DATES: Comments must be submitted on or before June 10, 2005.
FOR FURTHER INFORMATION OR A COPY OF THE SUBMISSION CONTACT: Denise
McLamb, Records Management Service (005E3), Department of Veterans
Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 273-8030,
fax (202) 273-5981 or e-mail to: denise.mclamb@mail.va.gov. Please
refer to ``OMB Control No. 2900-0629.''
Send comments and recommendations concerning any aspect of the
information collection to VA's OMB Desk Officer, OMB Human Resources
and Housing Branch, New Executive Office Building, Room 10235,
Washington, DC 20503, (202) 395-7316. Please refer to ``OMB Control No.
2900-0629'' in any correspondence.
SUPPLEMENTARY INFORMATION:
Title: Application for Extended Care Services, VA Form 10-10EC.
OMB Control Number: 2900-0629.
Type of Review: Extension of a currently approved collection.
Abstract: VA Form 10-10EC is used to gather current income and
financial information from nonservice-connected veterans and their
spouse when applying for extended care services and to establish a co-
payment agreement for such services. VA provides extended care to non-
service connected veterans who are unable to defray the necessary
expenses of care if their income is not greater than the maximum annual
pension rate. VA uses the data collected to establish the veteran's
eligibility for extended care services, financial liability, if any, of
the veteran to pay if accepted for placement or treatment in extended
care services, and to determine the appropriate co-payment.
An agency may not conduct or sponsor, and a person is not required
to respond to a collection of information unless it displays a
currently valid OMB control number. The Federal Register notice with a
60-day comment period soliciting comments on this collection of
information was published on January 5, 2005, at pages 939-940.
Affected Public: Individuals or Households.
Estimated Total Annual Burden: 9,000 hours.
Estimated Average Burden per Respondent: 90 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents: 6,000.
Dated: April 29, 2005.
By direction of the Secretary.
Loise Russell,
Director, Records Management Service.
[FR Doc. E5-2304 Filed 5-10-05; 8:45 am]
BILLING CODE 8320-01-P