Agency Information Collection (Agent Orange Registry Code Sheet) Activities Under OMB Review, 65207-65208 [E9-29305]

Download as PDF Federal Register / Vol. 74, No. 235 / Wednesday, December 9, 2009 / Notices DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0001] Agency Information Collection (Veteran’s Application for Compensation and/or Pension) Activities Under OMB Review WReier-Aviles on DSKGBLS3C1PROD with NOTICES AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. 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, will submit 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. DATE: Comments must be submitted on or before January 8, 2010. ADDRESSES: Submit written comments on the collection of information through http://www.Regulations.gov; or 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– 0001’’ in any correspondence. FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 461– 7485, fax (202) 273–0443 or e-mail denise.mclamb@mail.va.gov. Please refer to ‘‘OMB Control No. 2900–0001.’’ SUPPLEMENTARY INFORMATION: 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 VerDate Nov<24>2008 15:02 Dec 08, 2009 Jkt 220001 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. 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 September 9, 2009, at pages 49916– 49917. 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: December 4, 2009. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. E9–29304 Filed 12–8–09; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0376] Agency Information Collection (Agent Orange Registry Code Sheet) 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. 3501–3521), 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 PO 00000 Frm 00120 Fmt 4703 Sfmt 4703 65207 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 January 8, 2010. ADDRESSES: Submit written comments on the collection of information through http://www.Regulations.gov; or 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– 0376’’ in any correspondence. FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 461– 7485, fax (202) 273–0443 or e-mail denise.mclamb@mail.va.gov. Please refer to ‘‘OMB Control No. 2900–0376.’’ SUPPLEMENTARY INFORMATION: Title: Agent Orange Registry Code Sheet, VA Form 10–9009. OMB Control Number: 2900–0376. Type of Review: Extension of a currently approved collection. Abstract: VA in an ongoing 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 E:\FR\FM\09DEN1.SGM 09DEN1 65208 Federal Register / Vol. 74, No. 235 / Wednesday, December 9, 2009 / Notices 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. 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 September 29, 2009, at pages 49917– 49918. Affected Public: Individuals or Households. Estimated Total Annual Burden: 7,000 hours. Estimated Average Burden per Respondent: 20 minutes. Frequency of Response: On occasion. Estimated Number of Respondents: 21,000. Dated: December 4, 2009. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. E9–29305 Filed 12–8–09; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0335] Agency Information Collection (Dental Record Authorization and Invoice for Outpatient Services) Activity Under OMB Review WReier-Aviles on DSKGBLS3C1PROD with NOTICES AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. VerDate Nov<24>2008 15:02 Dec 08, 2009 Jkt 220001 SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501–3521), 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 January 8, 2010. ADDRESSES: Submit written comments on the collection of information through http://www.Regulations.gov; or 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– 0335’’ in any correspondence. FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 461– 7485, fax (202) 273–0443 or e-mail denise.mclamb@mail.va.gov. Please refer to ‘‘OMB Control No. 2900–0335.’’ SUPPLEMENTARY INFORMATION: 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 DATE: PO 00000 Frm 00121 Fmt 4703 Sfmt 4703 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. 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 September 29, 2009, on page 49918. 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: December 4, 2009. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. E9–29306 Filed 12–8–09; 8:45 am] BILLING CODE 8320–01–P E:\FR\FM\09DEN1.SGM 09DEN1

Agencies

[Federal Register Volume 74, Number 235 (Wednesday, December 9, 2009)]
[Notices]
[Pages 65207-65208]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-29305]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0376]


Agency Information Collection (Agent Orange Registry Code Sheet) 
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. 3501-3521), 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 January 8, 2010.

ADDRESSES: Submit written comments on the collection of information 
through http://www.Regulations.gov; or 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. 2900-0376'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records 
Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue, 
NW., Washington, DC 20420, (202) 461-7485, fax (202) 273-0443 or e-mail 
denise.mclamb@mail.va.gov. Please refer to ``OMB Control No. 2900-
0376.''

SUPPLEMENTARY INFORMATION:
    Title: Agent Orange Registry Code Sheet, VA Form 10-9009.
    OMB Control Number: 2900-0376.
    Type of Review: Extension of a currently approved collection.
    Abstract: VA in an ongoing 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

[[Page 65208]]

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.
    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 September 29, 2009, at pages 49917-49918.
    Affected Public: Individuals or Households.
    Estimated Total Annual Burden: 7,000 hours.
    Estimated Average Burden per Respondent: 20 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents: 21,000.

    Dated: December 4, 2009.

    By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9-29305 Filed 12-8-09; 8:45 am]
BILLING CODE 8320-01-P