Agency Information Collection Activities Under OMB Review, 61173 [E5-5780]
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Federal Register / Vol. 70, No. 202 / Thursday, October 20, 2005 / Notices
enrollment status. Benefits are not
payable when the student interrupts or
terminates a program. VA uses the
information to determine the student’s
entitlement to educational benefits or if
the student’s benefits should be
increased, decreased, or terminated.
Affected Public: State, Local or Tribal
Government, Business or other forprofit, and Not-for-profit institutions.
Estimated Annual Burden: 50,570
hours.
a. VA Form 22–1999b (Paper Copy)—
24, 670 hours.
b. VA Form 22–1999b (Electronically
Filed)—25,900 hours.
Estimated Average Burden Per
Respondent:
a. VA Form 22–1999b (Paper Copy)—
10 minutes.
b. VA Form 22–1999b (Electronically
Filed)—7 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
8,274.
Estimated Total Number of Responses
Annually: 370,000.
a. VA Form 22–1999b (Paper Copy)—
148,000.
b. VA Form 22–1999b (Electronically
Filed)—222,000.
Dated: October 11, 2005.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Records Management
Service.
[FR Doc. E5–5779 Filed 10–19–05; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0620]
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.
Comments must be submitted on
or before November 21, 2005.
DATE:
VerDate Aug<31>2005
16:14 Oct 19, 2005
Jkt 208001
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) 565–8374,
FAX (202) 565–6950 or e-mail to:
denise.mclamb@mail.va.gov. Please
refer to ‘‘OMB Control No. 2900–0620.’’
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–
0620’’ in any correspondence.
SUPPLEMENTARY INFORMATION:
Title: Payment and Reimbursement
for Emergency Services for Non ServiceConnected Conditions in Non-VA
Facilities.
OMB Control Number: 2900–0620.
Type of Review: Extension of a
currently approved collection.
Abstract: Veterans enrolled in VA’s
health-care system are personally liable
for emergency treatment rendered at
non-VA health facilities. Veterans or
their representative, and the health care
provider of the emergency treatment to
the veteran must submit a claim in
writing or complete a Health Insurance
Claim Form HCFA 1450 and 1500 or
Medical Uniform Institutional Provider
Bill Form UB–82 and 92 to request
payment or reimbursement for such
treatment. VA uses the data collected to
determine the claimant’s eligibility for
payment or reimbursement.
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 June
22, 2005, at page 36234.
Affected Public: Business or other forprofit, individuals or households, and
not-for-profit institutions.
Estimated Total Annual Burden:
147,187 hours.
Estimated Average Burden Per
Respondent: 30 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
294,373.
Dated: October 6, 2005.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Records Management
Service,
[FR Doc. E5–5780 Filed 10–19–05; 8:45 am]
BILLING CODE 8320–01–P
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61173
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0028]
Agency Information Collection
Activities Under OMB Review
Office of Information and
Technology, 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.
Comments must be submitted on
or before November 21, 2005.
DATES:
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) 565–8374,
FAX (202) 565–6950 or e-mail:
denise.mclamb@mail.va.gov. Please
refer to ‘‘OMB Control No. 2900–0028’’.
Send comments and
recommendations concerning any
aspect of the information collection to
VA’s 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–
0028’’.
SUPPLEMENTARY INFORMATION:
Titles:
a. Application of Service
Representative for Placement on Mailing
List, VA Form 3215.
b. Request for and Consent to Release
of Information from Claimant’s Records,
VA Form 3288.
c. Request to Correspondent for
Identifying Information, VA Form Letter
70–2.
d. 38 CFR 1.519(A) Lists of Names
and Addresses.
OMB Control Number: 2900–0028.
Type of Review: Extension of a
currently approved collection.
Abstract:
a. VA operates an outreach services
program to ensure veterans and
beneficiaries have information about
benefits and services to which they may
be entitled. To support the program, VA
E:\FR\FM\20OCN1.SGM
20OCN1
Agencies
[Federal Register Volume 70, Number 202 (Thursday, October 20, 2005)]
[Notices]
[Page 61173]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E5-5780]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0620]
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.
DATE: Comments must be submitted on or before November 21, 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) 565-8374,
FAX (202) 565-6950 or e-mail to: denise.mclamb@mail.va.gov. Please
refer to ``OMB Control No. 2900-0620.''
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.
2900-0620'' in any correspondence.
SUPPLEMENTARY INFORMATION:
Title: Payment and Reimbursement for Emergency Services for Non
Service-Connected Conditions in Non-VA Facilities.
OMB Control Number: 2900-0620.
Type of Review: Extension of a currently approved collection.
Abstract: Veterans enrolled in VA's health-care system are
personally liable for emergency treatment rendered at non-VA health
facilities. Veterans or their representative, and the health care
provider of the emergency treatment to the veteran must submit a claim
in writing or complete a Health Insurance Claim Form HCFA 1450 and 1500
or Medical Uniform Institutional Provider Bill Form UB-82 and 92 to
request payment or reimbursement for such treatment. VA uses the data
collected to determine the claimant's eligibility for payment or
reimbursement.
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 June 22, 2005, at page 36234.
Affected Public: Business or other for-profit, individuals or
households, and not-for-profit institutions.
Estimated Total Annual Burden: 147,187 hours.
Estimated Average Burden Per Respondent: 30 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents: 294,373.
Dated: October 6, 2005.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Records Management Service,
[FR Doc. E5-5780 Filed 10-19-05; 8:45 am]
BILLING CODE 8320-01-P