Proposed Information Collection (Eligibility Verification Reports); Comment Request, 27383-27384 [2011-11461]
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Federal Register / Vol. 76, No. 91 / Wednesday, May 11, 2011 / Notices
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0075]
Proposed Information Collection
(Statement in Support of Claim);
Comment Request
Veterans Benefits
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:
The Veterans Benefits
Administration (VBA), Department of
Veterans Affairs (VA), 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 information
needed to ensure statements submitted
by or on behalf of a claimant are true
and correct.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before July 11, 2011.
ADDRESSES: Submit written comments
on the collection of information through
Federal Docket Management System
(FDMS) at https://www.Regulations.gov
or to Nancy J. Kessinger, Veterans
Benefits Administration (20M33),
Department of Veterans Affairs, 810
Vermont Avenue, NW., Washington, DC
20420 or e-mail to
nancy.kessinger@va.gov. Please refer to
‘‘OMB Control No. 2900–0075’’ in any
correspondence. During the comment
period, comments may be viewed online
through FDMS.
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;
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SUMMARY:
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17:18 May 10, 2011
Jkt 223001
(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
of automated collection techniques or
the use of other forms of information
technology.
Title: Statement in Support of Claim,
VA Form 21–4138.
OMB Control Number: 2900–0075.
Type of Review: Extension of a
currently approved collection.
Abstract: Statements submitted by or
on behalf of a claimant must contain a
certification by the respondent that the
information provided to VA is true and
correct in support of various types of
benefit claims processed by VA. VA
Form 21–4138 is to used collect the
statement in support of such claims.
Affected Public: Individuals or
households.
Estimated Annual Burden: 188,000
hours.
Estimated Average Burden per
Respondent: 15 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
752,000.
Dated: May 5, 2011.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2011–11463 Filed 5–10–11; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0101]
Proposed Information Collection
(Eligibility Verification Reports);
Comment Request
Veterans Benefits
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:
The Veterans Benefits
Administration (VBA), Department of
Veterans Affairs (VA), 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
SUMMARY:
PO 00000
Frm 00083
Fmt 4703
Sfmt 4703
27383
notice solicits comments on information
needed to determine and verify
entitlement to income-based benefits.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before July 11, 2011.
ADDRESSES: Submit written comments
on the collection of information through
Federal Docket Management System
(FDMS) at https://www.Regulations.gov
or to Nancy J. Kessinger, Veterans
Benefits Administration (20M33),
Department of Veterans Affairs, 810
Vermont Avenue, NW., Washington, DC
20420 or e-mail to
nancy.kessinger@va.gov. Please refer to
‘‘OMB Control No. 2900–0101’’ in any
correspondence. During the comment
period, comments may be viewed online
through FDMS.
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
of automated collection techniques or
the use of other forms of information
technology.
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.
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27384
Federal Register / Vol. 76, No. 91 / Wednesday, May 11, 2011 / Notices
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
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: Extension 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.
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 98,775 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
and 21,450 for VA Forms 21–0517, 21–
0517–1, 21–0519S, and 21–0519S–1.
Dated: May 5, 2011.
VerDate Mar<15>2010
17:18 May 10, 2011
Jkt 223001
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2011–11461 Filed 5–10–11; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–New (VA Form 10–
0513)]
Agency Information Collection Activity
(Veteran Suicide Prevention Online
Quantitative Surveys) Under OMB
Review
Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:
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, 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 and it
includes the actual data collection
instrument.
SUMMARY:
Comments must be submitted on
or before June 10, 2011.
ADDRESSES: Submit written comments
on the collection of information through
https://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–
New (VA Form 10–0513)’’ in any
correspondence.
DATES:
FOR FURTHER INFORMATION OR A COPY OF
THE SUBMISSION CONTACT: Denise
McLamb, Enterprise Records Service
(005R1B), Department of Veterans
Affairs, 810 Vermont Avenue, NW.,
Washington, DC 20420, (202) 461–7485,
FAX (202) 461–0966 or e-mail:
denise.mclamb@va.gov. Please refer to
‘‘OMB Control No. 2900–New (VA Form
10–0513).’’
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.
PO 00000
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Fmt 4703
Sfmt 4703
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.
Titles
a. Veterans Online Survey, VA Form
10–0513.
b. Veterans Family Online Survey, VA
Form 10–0513a.
c. Veterans Primary Care Provider
Online Survey, VA Form 10–0513b.
OMB Control Number: 2900–New (VA
Form 10–0513).
Type of Review: New collection.
Abstract: VA’s top priority is the
prevention of Veterans suicide. It is
imperative to reach these at-risk
populations with proactive and trustworthy communications and focused
and effective outreach activities. As a
part of this outreach, VA will collect
information from Veterans, primary care
providers and families of veterans. Data
collected on the surveys will be used to
better understand Veterans and their
families’ awareness of VA’s suicide
prevention and mental health support
services. In addition, the surveys will
help gauge how Veterans view the need
for and willingness to accept help when
in crises or contemplating suicide.
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
February 18, 2011, at page 9637.
Affected Public: Individuals and
Households.
Estimated Annual Burden
a. Veterans Online Survey, VA Form
10–0513—300 hours.
b. Veterans Family Online Survey, VA
Form 10–0513a—300 hours.
c. Veterans Primary Care Provider
Online Survey, VA Form 10–0513b—
300 hours.
E:\FR\FM\11MYN1.SGM
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]]>Agencies
[Federal Register Volume 76, Number 91 (Wednesday, May 11, 2011)]
[Notices]
[Pages 27383-27384]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-11461]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0101]
Proposed Information Collection (Eligibility Verification
Reports); Comment Request
AGENCY: Veterans Benefits Administration, Department of Veterans
Affairs.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Veterans Benefits Administration (VBA), Department of
Veterans Affairs (VA), 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 information
needed to determine and verify entitlement to income-based benefits.
DATES: Written comments and recommendations on the proposed collection
of information should be received on or before July 11, 2011.
ADDRESSES: Submit written comments on the collection of information
through Federal Docket Management System (FDMS) at https://www.Regulations.gov or to Nancy J. Kessinger, Veterans Benefits
Administration (20M33), Department of Veterans Affairs, 810 Vermont
Avenue, NW., Washington, DC 20420 or e-mail to nancy.kessinger@va.gov.
Please refer to ``OMB Control No. 2900-0101'' in any correspondence.
During the comment period, comments may be viewed online through FDMS.
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
of automated collection techniques or the use of other forms of
information technology.
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.
[[Page 27384]]
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
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: Extension 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.
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 98,775 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 and 21,450 for VA Forms 21-0517, 21-0517-1, 21-0519S, and 21-
0519S-1.
Dated: May 5, 2011.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2011-11461 Filed 5-10-11; 8:45 am]
BILLING CODE 8320-01-P
