Proposed Information Collection (Annual-Final Report and Account) Activity: Comment Request, 39341-39342 [2012-16101]

Download as PDF Federal Register / Vol. 77, No. 127 / Monday, July 2, 2012 / Notices STATE INSURANCE DEPARTMENTS— Continued mstockstill on DSK4VPTVN1PROD with NOTICES State insurance departments Telephone No. Arkansas, Little Rock 72201–1904 .............. California, Sacramento 95814 ........................ Colorado, Denver 80202 ........................ Connecticut, Hartford 06142–0816 .............. Delaware, Dover 19904 District of Columbia, Washington 20002 .... Florida, Tallahassee 32399–0300 .............. Georgia, Atlanta 30334 Hawaii, Honolulu 96813 Idaho, Boise 83720– 0043 .......................... Illinois, Springfield 62767–0001 .............. Indiana, Indianapolis 46204–2787 .............. Iowa, Des Moines 50319 ........................ Kansas, Topeka 66612– 1678 .......................... Kentucky, Frankfort 40602–0517 .............. Louisiana, Baton Rouge 70802 ........................ Maine, Augusta 04333– 0034 .......................... Maryland, Baltimore 21202–2272 .............. Massachusetts, Boston 02110 ........................ Michigan, Lansing 48933–1020 .............. Minnesota, St. Paul 55101–2198 .............. Mississippi, Jackson 39201 ........................ Missouri, Jefferson City 65102 ........................ Montana, Helena 59601 Nebraska, Lincoln 68508 ........................ Nevada, Carson City 89701–5753 .............. New Hampshire, Concord 03301 ................ New Jersey, Trenton 08625 ........................ New Mexico, Santa Fe 87504–1269 .............. New York, New York 10004–2319 .............. North Carolina, Raleigh 27611 ........................ North Dakota, Bismarck 58505–0320 .............. Ohio, Columbus 43215– 1067 .......................... Oklahoma, Oklahoma City 73107 ................. Oregon, Salem 97301– 3883 .......................... Pennsylvania, Harrisburg 17120 ................ Puerto Rico, Santurce 00909 ........................ VerDate Mar<15>2010 17:22 Jun 29, 2012 STATE INSURANCE DEPARTMENTS— Continued State insurance departments Telephone No. (785) 296–3071 Rhode Island, Providence 02903–4233 ... South Carolina, Columbia 29202–3105 ........ South Dakota, Pierre 57501–3185 .............. Tennessee, Nashville 37243–0565 .............. Texas, Austin 78701 ..... Utah, Salt Lake City 84114–1201 .............. Vermont, Montpelier 05620–3101 .............. Virginia, Richmond 23218 ........................ Virgin Islands, St. Thomas 00802 .......... Washington, Olympia 98504–0255 .............. West Virginia, Charleston 25305–0540 ........ Wisconsin, Madison 53707–7873 .............. Wyoming, Cheyenne 82002–0440 .............. (502) 564–6027 [FR Doc. 2012–15800 Filed 6–29–12; 8:45 am] (225) 342–5423 BILLING CODE 4810–35–P (501) 371–2600 (916) 492–3500 (303) 894–7499 (860) 297–3800 (302) 674–7300 (202) 442–7813 (850) 413–2850 (404) 656–2056 (808) 586–2790 (208) 334–4250 (217) 782–4515 (317) 232–2385 (515) 281–5705 (401) 462–9500 (803) 737–6160 (605) 773–4104 (615) 741–2176 (800) 578–4677 (801) 538–3800 (802) 828–3301 (800) 552–7945 (340) 774–7166 (360) 725–7144 (304) 558–3354 (608) 266–3586 (307) 777–7401 (207) 624–8475 (410) 468–2000 DEPARTMENT OF VETERANS AFFAIRS (617) 521–7794 [OMB Control No. 2900–0017] (517) 373–0220 (651) 296–6025 Proposed Information Collection (Annual-Final Report and Account) Activity: Comment Request (601) 359–3569 Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. (402) 471–2201 SUMMARY: The Veterans Benefits (775) 687–0700 Administration (VBA), Department of (603) 271–2261 Veterans Affairs (VA), is announcing an opportunity for public comment on the (609) 292–5360 proposed collection of certain information by the agency. Under the (800) 947–4722 Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to (212) 480–2289 publish notice in the Federal Register concerning each proposed collection of (919) 807–6750 information, including each proposed (701) 328–2440 extension of a currently approved collection, and allow 60 days for public (614) 644–2658 comment in response to the notice. This notice solicits comments on the (405) 521–2828 information needed to ensure fiduciaries are properly administering (503) 947–7980 VA beneficiaries’ compensation and pension payments. (877)881–6388 DATES: Written comments and (787) 722–8686 recommendations on the proposed AGENCY: (573) 751–4126 (406) 444–2040 Jkt 226001 PO 00000 Frm 00134 Fmt 4703 Sfmt 4703 39341 collection of information should be received on or before August 31, 2012. ADDRESSES: Submit written comments on the collection of information through Federal Docket Management System (FDMS) at www.Regulations.gov or to Nancy J. Kessinger, Veterans Benefits Administration (20M33), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420 or email to nancy.kessinger@va.gov. Please refer to ‘‘OMB Control No. 2900–0017’’ 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 (Public Law 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: a. Annual-Final Report and Account, VA Form 21–4706. b. Federal Fiduciary’s Account, VA Form 21–4706b. c. Court Appointed Fiduciary’s Account, VA Form 21–4706c. d. Account Book, VA Form 21–4718. e. Certificate of Balance on Deposit and Authorization to Disclose Financial Records (Pursuant to Title 38, U.S.C., Chapter 55 and Title 12, U.S.C., Chapter 35), VA Form 21–4718a. OMB Control Number: 2900–0017. Type of Review: Extension of a currently approved collection. Abstract: VA maintain supervision of the distribution and use of VA benefits paid to fiduciaries on behalf of VA claimants who are incompetent, a minor, or under legal disability. The forms are used to verify beneficiaries’ deposit remaining at a financial E:\FR\FM\02JYN1.SGM 02JYN1 mstockstill on DSK4VPTVN1PROD with NOTICES 39342 Federal Register / Vol. 77, No. 127 / Monday, July 2, 2012 / Notices institution against a fiduciary’s accounting. The following forms will be used to ensure claimants’ benefits payments are administered properly. a. VA Forms 21–4706, 4706b and 4706c are used by estate to determine proper usage of benefits paid to fiduciaries. The 21–4706 and 21–4706b are both necessary to conform to requirement of various state courts. b. VA Form 21–4718 is provided to VA fiduciaries to submit accountings to either State courts or the VA. It is not a reporting form per se, but a vehicle to assist the fiduciary in accurately maintaining records of monies received and spent. c. VA Form 21–4718a—Fiduciaries are required to obtain certifications that the balances remaining on deposit in financial institutions as shown on accountings are correct. Certifying official at a financial institution completing the form must affix the institution’s official seal or stamp. The data collected is used to appoint an appropriate fiduciary for a VA beneficiary and to prevent fiduciaries from supplying false certification, embezzling funds, and possibly prevent and/or identify fraud, waste and abuse of government funds paid to fiduciaries on behalf of VA beneficiaries. Affected Public: Individuals or households. Estimated Annual Burden: a. Annual-Final Report and Account, VA Form 21–4706—1,100. b. Federal Fiduciary’s Account, VA Form 21–4706b—6,300. c. Court Appointed Fiduciary’s Account, VA Form 21–4706c—2,000. d. Account Book, VA Form 21–4718— 20,000. e. Certificate of Balance on Deposit and Authorization to Disclose Financial Records, VA Form 21–4718a—166. Estimated Average Burden per Respondent: a. Annual-Final Report and Account, VA Form 21–4706—30 minutes. b. Federal Fiduciary’s Accounts, VA Form 21–4706b—27 minutes. c. Court Appointed Fiduciary’s Account, VA Form 21–4706c—30 minutes. d. Account Book, VA Form 21–4718— 21⁄2 hours. e. Certificate of Balance on Deposit and Authorization to Disclose Financial Records, VA Form 21–4718a—3 minutes. Frequency of Response: Annually. Estimated Number of Respondents: a. Annual-Final Report and Account, VA Form 21–4706—2,200. b. Federal Fiduciary’s Accounts, VA Form 21–4706b—14,000. c. Court Appointed Fiduciary’s Account, VA Form 21–4706c—4,000. VerDate Mar<15>2010 17:22 Jun 29, 2012 Jkt 226001 d. Account Book, VA Form 21–4718— 8,000. e. Certificate of Balance on Deposit and Authorization to Disclose Financial Records, VA Form 21–4718a—3,312. Dated: June 27, 2012. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. 2012–16101 Filed 6–29–12; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0554] Proposed Information Collection (Homeless Providers Grant and Per Diem Program) Activity; Comment Request Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: The Veterans Health Administration (VHA), 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 revision 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 an applicant’s eligibility to receive a grant and/or per diem for programs to assist homeless veterans’ transition to independent living and to determine if the grantee is meeting the objectives outlined in the original grant application. SUMMARY: Written comments and recommendations on the proposed collection of information should be received on or before August 31, 2012. ADDRESSES: Submit written comments on the collection of information through Federal Docket Management System (FDMS) at www.Regulations.gov; or to Cynthia Harvey-Pryor, Veterans Health Administration (10P7BFP), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420; or email: cynthia.harvey-pryor@va.gov. Please refer to ‘‘OMB Control No. 2900– 0554’’ in any correspondence. During the comment period, comments may be viewed online through the FDMS. DATES: PO 00000 Frm 00135 Fmt 4703 Sfmt 4703 FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor (202) 461–5870 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. Titles a. Homeless Providers Grant and Per Diem Program, Capital Grant. Application, VA Form 10–0361–CG. b. Homeless Providers Grant and Per Diem Program, Life Safety Code Application, VA Form 10–0361–LSC. c. Homeless Providers Grant and Per Diem Program, Per Diem Only Application, VA Form 10–0361–PDO. d. Homeless Providers Grant and Per Diem Program, Special Needs Application, VA Form 10–0361–SN. e. Compliance Reports for Per Diem and Special Needs Grants. No form needed. May be reported to VA in standard business narrative. f. Homeless Providers Grant and Per Diem Program, Technical Assistance Application, VA Form 10–0361–TA. g. Compliance Reports for Technical Assistance Grants. No form needed. May be reported to VA in standard business narrative. OMB Control Number: 2900–0554. Type of Review: Revision of a currently approved collection. Abstract: VA Form 10–0361 series, Homeless Providers Grant and Per Diem Program, will be used to evaluate applicants eligibility to receive a grant and/or per diem payments, apply the specific criteria to rate and rank each application; and to obtain information necessary to ensure that Federal funds are awarded to applicants who are financially stable and who will conduct E:\FR\FM\02JYN1.SGM 02JYN1

Agencies

[Federal Register Volume 77, Number 127 (Monday, July 2, 2012)]
[Notices]
[Pages 39341-39342]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-16101]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0017]


Proposed Information Collection (Annual-Final Report and Account) 
Activity: 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 the 
information needed to ensure fiduciaries are properly administering VA 
beneficiaries' compensation and pension payments.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before August 31, 2012.

ADDRESSES: Submit written comments on the collection of information 
through Federal Docket Management System (FDMS) at www.Regulations.gov 
or to Nancy J. Kessinger, Veterans Benefits Administration (20M33), 
Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 
20420 or email to nancy.kessinger@va.gov. Please refer to ``OMB Control 
No. 2900-0017'' 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 (Public Law 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:
    a. Annual-Final Report and Account, VA Form 21-4706.
    b. Federal Fiduciary's Account, VA Form 21-4706b.
    c. Court Appointed Fiduciary's Account, VA Form 21-4706c.
    d. Account Book, VA Form 21-4718.
    e. Certificate of Balance on Deposit and Authorization to Disclose 
Financial Records (Pursuant to Title 38, U.S.C., Chapter 55 and Title 
12, U.S.C., Chapter 35), VA Form 21-4718a.
    OMB Control Number: 2900-0017.
    Type of Review: Extension of a currently approved collection.
    Abstract: VA maintain supervision of the distribution and use of VA 
benefits paid to fiduciaries on behalf of VA claimants who are 
incompetent, a minor, or under legal disability. The forms are used to 
verify beneficiaries' deposit remaining at a financial

[[Page 39342]]

institution against a fiduciary's accounting. The following forms will 
be used to ensure claimants' benefits payments are administered 
properly.
    a. VA Forms 21-4706, 4706b and 4706c are used by estate to 
determine proper usage of benefits paid to fiduciaries. The 21-4706 and 
21-4706b are both necessary to conform to requirement of various state 
courts.
    b. VA Form 21-4718 is provided to VA fiduciaries to submit 
accountings to either State courts or the VA. It is not a reporting 
form per se, but a vehicle to assist the fiduciary in accurately 
maintaining records of monies received and spent.
    c. VA Form 21-4718a--Fiduciaries are required to obtain 
certifications that the balances remaining on deposit in financial 
institutions as shown on accountings are correct. Certifying official 
at a financial institution completing the form must affix the 
institution's official seal or stamp. The data collected is used to 
appoint an appropriate fiduciary for a VA beneficiary and to prevent 
fiduciaries from supplying false certification, embezzling funds, and 
possibly prevent and/or identify fraud, waste and abuse of government 
funds paid to fiduciaries on behalf of VA beneficiaries.
    Affected Public: Individuals or households.
    Estimated Annual Burden:
    a. Annual-Final Report and Account, VA Form 21-4706--1,100.
    b. Federal Fiduciary's Account, VA Form 21-4706b--6,300.
    c. Court Appointed Fiduciary's Account, VA Form 21-4706c--2,000.
    d. Account Book, VA Form 21-4718--20,000.
    e. Certificate of Balance on Deposit and Authorization to Disclose 
Financial Records, VA Form 21-4718a--166.
    Estimated Average Burden per Respondent:
    a. Annual-Final Report and Account, VA Form 21-4706--30 minutes.
    b. Federal Fiduciary's Accounts, VA Form 21-4706b--27 minutes.
    c. Court Appointed Fiduciary's Account, VA Form 21-4706c--30 
minutes.
    d. Account Book, VA Form 21-4718--2\1/2\ hours.
    e. Certificate of Balance on Deposit and Authorization to Disclose 
Financial Records, VA Form 21-4718a--3 minutes.
    Frequency of Response: Annually.
    Estimated Number of Respondents:
    a. Annual-Final Report and Account, VA Form 21-4706--2,200.
    b. Federal Fiduciary's Accounts, VA Form 21-4706b--14,000.
    c. Court Appointed Fiduciary's Account, VA Form 21-4706c--4,000.
    d. Account Book, VA Form 21-4718--8,000.
    e. Certificate of Balance on Deposit and Authorization to Disclose 
Financial Records, VA Form 21-4718a--3,312.

    Dated: June 27, 2012.

    By direction of the Secretary.

Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2012-16101 Filed 6-29-12; 8:45 am]
BILLING CODE 8320-01-P
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