Agency Information Collection (Operation Enduring Freedom/Operation Iraqi Freedom Seriously Injured/Ill Service Member Veteran Worksheet): Activity Under OMB Review, 73022-73023 [2011-30502]
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73022
Federal Register / Vol. 76, No. 228 / Monday, November 28, 2011 / Notices
Please refer to ‘‘OMB Control No. 2900–
0104’’ 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) 461–0966 or email
denise.mclamb@va.gov. Please refer to
‘‘OMB Control No. 2900–0104.’’
SUPPLEMENTARY INFORMATION:
Title: Report of Accidental Injury in
Support of Claim for Compensation or
Pension/Statement of Witness to
Accident, VA Form 21–4176.
OMB Control Number: 2900–0104.
Type of Review: Extension of a
currently approved collection.
Abstract: VA Form 21–4176 is used to
support a claim for disability benefits
based on an accidental injury that a
veteran incurred while in the line of
duty. VA will use the data collected to
determine whether the injury was
accidental or a result of willful
misconduct by the veteran.
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 21, 2011, at pages 58566–
58567.
Affected Public: Individuals or
households.
Estimated Annual Burden: 2,200
hours.
Estimated Average Burden per
Respondent: 30 minutes.
Frequency of Response: One-time.
Estimated Number of Respondents:
4,400.
Dated: November 22, 2011.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2011–30504 Filed 11–25–11; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
pmangrum on DSK3VPTVN1PROD with NOTICES
[OMB Control No. 2900–0108]
Agency Information Collection (Report
of Income From Property or Business):
Activity Under OMB Review
Veterans Benefits
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:
In compliance with the
Paperwork Reduction Act (PRA) of 1995
SUMMARY:
VerDate Mar<15>2010
15:34 Nov 25, 2011
Jkt 226001
(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.
DATES: Comments must be submitted on
or before December 28, 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–
0108’’ 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) 461–0966 or email
denise.mclamb@va.gov. Please refer to
‘‘OMB Control No. 2900–0108.’’
SUPPLEMENTARY INFORMATION:
Title: Report of Income from Property
or Business, VA Form 21–4185.
OMB Control Number: 2900–0108.
Type of Review: Extension of a
currently approved collection.
Abstract: Claimants complete VA
Form 21–4185 to report income and
expenses that derived from rental
property and/or operation of a business.
VA uses the information to determine
whether the claimant is eligible for VA
benefits and, if eligibility exists, the
proper rate of 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
September 21, 2011, at page 58566.
Affected Public: Individuals or
households.
Estimated Annual Burden: 3,500
hours.
Estimated Average Burden per
Respondent: 30 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
7,000.
Dated: November 22, 2011.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2011–30505 Filed 11–25–11; 8:45 am]
BILLING CODE 8320–01–P
PO 00000
Frm 00126
Fmt 4703
Sfmt 4703
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0720]
Agency Information Collection
(Operation Enduring Freedom/
Operation Iraqi Freedom Seriously
Injured/Ill Service Member Veteran
Worksheet): Activity Under OMB
Review
Veterans Benefits
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:
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.
DATES: Comments must be submitted on
or before December 28, 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–
0720’’ 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) 461–0966 or email
denise.mclamb@va.gov. Please refer to
‘‘OMB Control No. 2900–0720.’’
SUPPLEMENTARY INFORMATION:
Title: Operation Enduring Freedom/
Operation Iraqi Freedom Seriously
Injured/Ill Service Member Veteran
Worksheet, VA Form 21–0773.
OMB Control Number: 2900–0720.
Type of Review: Extension of a
currently approved collection.
Abstract: Veterans Service
Representatives used VA Form 21–0773
as a checklist to ensure they provided
Operation Enduring Freedom or
Operation Iraqi Freedom service
members who have at least six months
remaining on active duty and may have
suffered a serious injury or illness, with
information, applications, and/or
referral service regarding VA benefits.
An agency may not conduct or
sponsor, and a person is not required to
SUMMARY:
E:\FR\FM\28NON1.SGM
28NON1
Federal Register / Vol. 76, No. 228 / Monday, November 28, 2011 / Notices
pmangrum on DSK3VPTVN1PROD with NOTICES
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 21, 2011, at page 58565.
VerDate Mar<15>2010
15:34 Nov 25, 2011
Jkt 226001
Affected Public: Individuals or
households.
Estimated Annual Burden: 7,000
hours.
Estimated Average Burden per
Respondent: 30 minutes.
Frequency of Response: One time.
Estimated Number of Respondents:
14,000.
PO 00000
Frm 00127
Fmt 4703
Sfmt 9990
73023
Dated: November 22, 2011.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2011–30502 Filed 11–25–11; 8:45 am]
BILLING CODE 8320–01–P
E:\FR\FM\28NON1.SGM
28NON1
Agencies
[Federal Register Volume 76, Number 228 (Monday, November 28, 2011)]
[Notices]
[Pages 73022-73023]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-30502]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0720]
Agency Information Collection (Operation Enduring Freedom/
Operation Iraqi Freedom Seriously Injured/Ill Service Member Veteran
Worksheet): Activity Under OMB Review
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.
DATES: Comments must be submitted on or before December 28, 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. 2900-0720'' 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) 461-0966 or email
denise.mclamb@va.gov. Please refer to ``OMB Control No. 2900-0720.''
SUPPLEMENTARY INFORMATION:
Title: Operation Enduring Freedom/Operation Iraqi Freedom Seriously
Injured/Ill Service Member Veteran Worksheet, VA Form 21-0773.
OMB Control Number: 2900-0720.
Type of Review: Extension of a currently approved collection.
Abstract: Veterans Service Representatives used VA Form 21-0773 as
a checklist to ensure they provided Operation Enduring Freedom or
Operation Iraqi Freedom service members who have at least six months
remaining on active duty and may have suffered a serious injury or
illness, with information, applications, and/or referral service
regarding VA benefits.
An agency may not conduct or sponsor, and a person is not required
to
[[Page 73023]]
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 21, 2011, at page 58565.
Affected Public: Individuals or households.
Estimated Annual Burden: 7,000 hours.
Estimated Average Burden per Respondent: 30 minutes.
Frequency of Response: One time.
Estimated Number of Respondents: 14,000.
Dated: November 22, 2011.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2011-30502 Filed 11-25-11; 8:45 am]
BILLING CODE 8320-01-P