Proposed Information Collection (Agent Orange Registry Code Sheet); Comment Request, 49917-49918 [E9-23411]
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Federal Register / Vol. 74, No. 187 / Tuesday, September 29, 2009 / Notices
opportunity for public comment on the
proposed collection of certain
information by the Agency. Under the
Paperwork Reduction Act (PRA) of
1995, Federal agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information, including each revision of
a currently approved collection and
allow 60 days for public comment in
response to the notice. This notice
solicits comments on information
needed to determine a veteran’s
eligibility, dependency, and income, as
applicable, for compensation and/or
pension benefits and to assist veterans
in reopening a previously denied
disability compensation claim or to
request an increase in benefit and/or
claim for a new service-connected
condition.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before November 30,
2009.
Submit written comments
on the collection of information through
https://www.Regulations.gov; or to Nancy
J. Kessinger, Veterans Benefits
Administration (20M35), Department of
Veterans Affairs, 810 Vermont Avenue,
NW., Washington, DC 20420 or e-mail:
nancy.kessinger@va.gov. Please refer to
‘‘OMB Control No. 2900–0001’’ in any
correspondence. During the comment
period, comments may be viewed online
through the Federal Docket Management
System (FDMS) at https://
www.Regulations.gov.
jlentini on DSKJ8SOYB1PROD with NOTICES
ADDRESSES:
FOR FURTHER INFORMATION CONTACT:
Nancy J. Kessinger at (202) 461–9769 or
FAX (202) 275–5947.
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, VBA invites
comments on: (1) Whether the proposed
collection of information is necessary
for the proper performance of VBA’s
functions, including whether the
information will have practical utility;
(2) the accuracy of VBA’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
VerDate Nov<24>2008
16:18 Sep 28, 2009
Jkt 217001
of automated collection techniques or
the use of other forms of information
technology.
Titles:
a. Veteran’s Application for
Compensation and/or Pension, VA Form
21–526.
b. Veteran’s Supplemental Claim
Application, VA Form 21–526b.
c. Authorization and Consent Release
Information to the Department of
Veterans Affairs (VA), VA Form 21–
4142.
OMB Control Number: 2900–0001.
Type of Review: Revision of a
currently approved collection.
Abstracts:
a. Veterans complete VA Form 21–526
to apply for compensation and/or
pension benefits.
b. Veterans who previously filed a
claim using VA Form 21–526,
Application for Compensation or
Pension, and who wish to request an
increase in a service connected
condition, reopen their claim for a
previously denied claim, and/or file a
claim for a new service-connected
condition must complete VA Form 21–
526b. VA Form 21–526b will be used for
supplemental claims for disability
compensation.
c. Veterans who need VA’s assistance
in obtaining non-VA medical records
must complete VA Form 21–4142.
Affected Public: Individuals or
households.
Estimated Annual Burden:
a. VA Form 21–526—391,708.
b. VA Form 21–526b—50,000.
c. VA Form 21–4142—274.
Estimated Average Burden Per
Respondent:
a. VA Form 21–526—1 hour.
b. VA Form 21–526b—15 minutes
c. VA Form 21–4142—5 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
a. VA Form 21–526—391,708
b. VA Form 21–526b—200,000
c. VA Form 21–4142—3,292.
Dated: September 24, 2009.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9–23481 Filed 9–28–09; 8:45 am]
BILLING CODE P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0376]
Proposed Information Collection
(Agent Orange Registry Code Sheet);
Comment Request
AGENCY: Veterans Health
Administration, Department of Veterans
Affairs.
PO 00000
Frm 00070
Fmt 4703
Sfmt 4703
ACTION:
49917
Notice.
SUMMARY: The Veterans Health
Administration (VHA) is announcing an
opportunity for public comment on the
proposed collection of certain
information by the agency. Under the
Paperwork Reduction Act (PRA) of
1995, Federal agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information, including each proposed
extension of a currently approved
collection, and allow 60 days for public
comment in response to the notice. This
notice solicits comments on the
information needed to maintain an upto-date Agent Orange Registry.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before November 30,
2009.
ADDRESSES: Submit written comments
on the collection of information through
the Federal Docket Management System
(FDMS) at https://www.Regulations.gov;
or to Mary Stout, Veterans Health
Administration (193E1), Department of
Veterans Affairs, 810 Vermont Avenue,
NW., Washington, DC 20420 or e-mail:
mary.stout@va.gov. Please refer to
‘‘OMB Control No. 2900–0376’’ in any
correspondence. During the comment
period, comments may be viewed online
through FDMS.
FOR FURTHER INFORMATION CONTACT:
Mary Stout at (202) 461–5867 or FAX
(202) 273–9381.
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, VHA invites
comments on: (1) Whether the proposed
collection of information is necessary
for the proper performance of VHA’s
functions, including whether the
information will have practical utility;
(2) the accuracy of VHA’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: Agent Orange Registry Code
Sheet, VA Form 10–9009.
E:\FR\FM\29SEN1.SGM
29SEN1
49918
Federal Register / Vol. 74, No. 187 / Tuesday, September 29, 2009 / Notices
jlentini on DSKJ8SOYB1PROD with NOTICES
OMB Control Number: 2900–0376.
Type of Review: Extension of a
currently approved collection.
Abstract: VA in an on-going effort to
maintain an Agent Orange Registry
(AOR) developed a reporting format to
facilitate the collection of information
obtained from veterans during the Agent
Orange registry examination process.
VA is required to organize and update
the information contained in AOR to be
able to notify Vietnam era veterans who
served in the Republic of Vietnam of
any increased health risks resulting
from exposure to dioxin or other toxic
agents. VA may also provide, upon
request, a health examination,
consultation, and counseling veterans
who are eligible for listing or inclusion
in any health-related registry
administrated by VA that is similar to
the Persian Gulf War Veterans Health
Registry. Registry examinations is
provided to veterans who served in
Korea in 1968 or 1969, and/or any U.S.
veteran who may have been exposed to
dioxin, or other toxic substance in a
herbicide or defoliant, during the
conduct of, or as a result of, the testing,
transporting, or spraying of herbicides,
and who requests an Agent Orange
Registry examination. VA will enter the
information obtained from the veteran
during the interview on VA Form 10–
9009, Agent Orange Registry Code
Sheet. The registry will provide a
mechanism that will catalogue
prominent symptoms, reproductive
health, and diagnoses and to
communicate with Agent Orange
veterans. VA will inform the veterans on
research finding or new compensation
policies through periodic newsletters.
The registry is not designed or intended
to be a research tool and therefore the
results cannot be generalized to
represent all Agent Orange veterans.
Affected Public: Individuals or
Households.
Estimated Total Annual Burden:
6,667 hours.
Estimated Average Burden per
Respondent: 20 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
6,667.
Dated: September 24, 2009.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9–23411 Filed 9–28–09; 8:45 am]
BILLING CODE 8320–01–P
VerDate Nov<24>2008
16:18 Sep 28, 2009
Jkt 217001
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0335]
Proposed Information Collection
(Dental Record Authorization and
Invoice for Outpatient Services)
Activity: Comment Request
AGENCY: Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
SUMMARY: The Veterans Health
Administration (VHA) is announcing an
opportunity for public comment on the
proposed collection of certain
information by the agency. Under the
Paperwork Reduction Act (PRA) of
1995, Federal agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information, including each proposed
extension of a currently approved
collection, and allow 60 days for public
comment in response to the notice. This
notice solicits comments on the
information needed to determine a
veteran’s dental treatment needs, and
the fees associated for these services.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before November 30,
2009.
ADDRESSES: Submit written comments
on the collection of information through
Federal Docket Management System
(FDMS) at https://www.Regulations.gov;
or to Mary Stout, Veterans Health
Administration (193E1), Department of
Veterans Affairs, 810 Vermont Avenue,
NW., Washington, DC 20420 or e-mail:
mary.stout@va.gov. Please refer to
‘‘OMB Control No. 2900–0335’’ in any
correspondence. During the comment
period, comments may be viewed online
through FDMS.
FOR FURTHER INFORMATION CONTACT:
Mary Stout (202) 461–5867 or FAX (202)
273–9381.
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, VHA invites
comments on: (1) Whether the proposed
collection of information is necessary
for the proper performance of VHA’s
functions, including whether the
information will have practical utility;
PO 00000
Frm 00071
Fmt 4703
Sfmt 4703
(2) the accuracy of VHA’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: Dental Record Authorization
and Invoice for Outpatient Services, VA
Form 10–2570d.
OMB Control Number: 2900–0335.
Type of Review: Extension of a
currently approved collection.
Abstract: VA Form 10–2570d is
essential to the proper administration of
VA outpatient fee dental program. The
associated instructions make it possible
to communicate with clarity the
required procedures, peculiarities, and
precautions associated with VA
authorizations for contracting with
private dentists for the provision of
dental treatment for eligible veteran
beneficiaries. Since most of the veterans
who are authorized fee dental care are
geographically inaccessible to VA dental
clinics, it is necessary to request
information as to the veteran’s oral
condition, treatment needs and the
usual customary fees for these services
from the private fee dentist whom the
veteran has selected. The form lists the
dental treatment needs of the veteran
patient, the cost to VA to provide such
services, and serves as an invoice for
payment. VA uses the data collected to
verify the veteran’s eligibility to receive
dental benefits.
Affected Public: Business and other
for profit.
Estimated Total Annual Burden:
3,666 hours.
Estimated Average Burden per
Respondent: 20 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
11,000.
Dated: September 24, 2009.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9–23412 Filed 9–28–09; 8:45 am]
BILLING CODE 8320–01–P
E:\FR\FM\29SEN1.SGM
29SEN1
]]>Agencies
[Federal Register Volume 74, Number 187 (Tuesday, September 29, 2009)]
[Notices]
[Pages 49917-49918]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-23411]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0376]
Proposed Information Collection (Agent Orange Registry Code
Sheet); Comment Request
AGENCY: Veterans Health Administration, Department of Veterans Affairs.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Veterans Health Administration (VHA) is announcing an
opportunity for public comment on the proposed collection of certain
information by the agency. Under the Paperwork Reduction Act (PRA) of
1995, Federal agencies are required to publish notice in the Federal
Register concerning each proposed collection of information, including
each proposed extension of a currently approved collection, and allow
60 days for public comment in response to the notice. This notice
solicits comments on the information needed to maintain an up-to-date
Agent Orange Registry.
DATES: Written comments and recommendations on the proposed collection
of information should be received on or before November 30, 2009.
ADDRESSES: Submit written comments on the collection of information
through the Federal Docket Management System (FDMS) at https://www.Regulations.gov; or to Mary Stout, Veterans Health Administration
(193E1), Department of Veterans Affairs, 810 Vermont Avenue, NW.,
Washington, DC 20420 or e-mail: mary.stout@va.gov. Please refer to
``OMB Control No. 2900-0376'' in any correspondence. During the comment
period, comments may be viewed online through FDMS.
FOR FURTHER INFORMATION CONTACT: Mary Stout at (202) 461-5867 or FAX
(202) 273-9381.
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, VHA
invites comments on: (1) Whether the proposed collection of information
is necessary for the proper performance of VHA's functions, including
whether the information will have practical utility; (2) the accuracy
of VHA'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: Agent Orange Registry Code Sheet, VA Form 10-9009.
[[Page 49918]]
OMB Control Number: 2900-0376.
Type of Review: Extension of a currently approved collection.
Abstract: VA in an on-going effort to maintain an Agent Orange
Registry (AOR) developed a reporting format to facilitate the
collection of information obtained from veterans during the Agent
Orange registry examination process. VA is required to organize and
update the information contained in AOR to be able to notify Vietnam
era veterans who served in the Republic of Vietnam of any increased
health risks resulting from exposure to dioxin or other toxic agents.
VA may also provide, upon request, a health examination, consultation,
and counseling veterans who are eligible for listing or inclusion in
any health-related registry administrated by VA that is similar to the
Persian Gulf War Veterans Health Registry. Registry examinations is
provided to veterans who served in Korea in 1968 or 1969, and/or any
U.S. veteran who may have been exposed to dioxin, or other toxic
substance in a herbicide or defoliant, during the conduct of, or as a
result of, the testing, transporting, or spraying of herbicides, and
who requests an Agent Orange Registry examination. VA will enter the
information obtained from the veteran during the interview on VA Form
10-9009, Agent Orange Registry Code Sheet. The registry will provide a
mechanism that will catalogue prominent symptoms, reproductive health,
and diagnoses and to communicate with Agent Orange veterans. VA will
inform the veterans on research finding or new compensation policies
through periodic newsletters. The registry is not designed or intended
to be a research tool and therefore the results cannot be generalized
to represent all Agent Orange veterans.
Affected Public: Individuals or Households.
Estimated Total Annual Burden: 6,667 hours.
Estimated Average Burden per Respondent: 20 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents: 6,667.
Dated: September 24, 2009.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9-23411 Filed 9-28-09; 8:45 am]
BILLING CODE 8320-01-P
