Agency Information Collection (Report of Accidental Injury in Support of Claim for Compensation or Pension/Statement of Witness to Accident): Activity Under OMB Review, 73021-73022 [2011-30504]

Download as PDF Federal Register / Vol. 76, No. 228 / Monday, November 28, 2011 / Notices 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– 0580’’ 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. 2900–0580.’’ SUPPLEMENTARY INFORMATION: Title: Request for Transportation Expense Reimbursement (38 CFR 21.8370). OMB Control Number: 2900–0580. Type of Review: Extension of a currently approved collection. Abstract: Children of Vietnam veterans born with spina bifida and receiving vocational training or seeking employment may request reimbursement for transportation expenses. To be eligible, the child must provide supportive documentation of actual expenses incurred for the travel. VA uses the information collected to determine if the child is unable to pursue training or employment without travel assistance. 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 58567. Affected Public: Individuals or households. Estimated Annual Burden: 63 hours. Estimated Average Burden per Respondent: 6 minutes. Frequency of Response: Monthly. Estimated Number of Respondents: 50. pmangrum on DSK3VPTVN1PROD with NOTICES SUMMARY: VerDate Mar<15>2010 15:34 Nov 25, 2011 Jkt 226001 Estimated Total Annual Responses: 600. Dated: November 22, 2011. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. 2011–30508 Filed 11–25–11; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0721] Agency Information Collection (Exam for Housebound Status or Permanent Need for Regular Aid and Attendance): 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– 0721’’ 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. 2900–0721.’’ SUPPLEMENTARY INFORMATION: Title: Exam for Housebound Status or Permanent Need for Regular Aid and Attendance, VA Form 21–2680. OMB Control Number: 2900–0721. Type of Review: Extension of a currently approved collection. Abstract: VA will use VA Form 21– 2680 to gather medical information that is necessary to determine beneficiaries or claimants receiving treatment from SUMMARY: PO 00000 Frm 00125 Fmt 4703 Sfmt 4703 73021 private doctors or physicians, eligibility for aid and attendance or housebound benefit. 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 58565– 58566. Affected Public: Business or other forprofit. 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. 2011–30503 Filed 11–25–11; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0104] Agency Information Collection (Report of Accidental Injury in Support of Claim for Compensation or Pension/ Statement of Witness to Accident): 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. SUMMARY: E:\FR\FM\28NON1.SGM 28NON1 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

Agencies

[Federal Register Volume 76, Number 228 (Monday, November 28, 2011)]
[Notices]
[Pages 73021-73022]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-30504]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0104]


Agency Information Collection (Report of Accidental Injury in 
Support of Claim for Compensation or Pension/Statement of Witness to 
Accident): 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.

[[Page 73022]]

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
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