Agency Information Collection (Dental Record Authorization and Invoice for Outpatient Services) Activity Under OMB Review, 6851-6852 [2013-02028]

Download as PDF Federal Register / Vol. 78, No. 21 / Thursday, January 31, 2013 / Notices Type of Review: Extension of a currently approved collection. Abstract: The data collected on VA Form 26–8261a will be used to determine Veteran applicants’ eligibility to receive a reduced down payment on a Federal Housing Administration (FHA) backed loan. 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 October 19, 2012, at page 64386. Affected Public: Individuals or households. Estimated Annual Burden: 4 hours. Estimated Average Burden per Respondent: 10 minutes. Frequency of Response: One time. Estimated Number of Respondents: 25. Dated: January 25, 2012. By direction of the Secretary. William F. Russo, Deputy Director, Office of Regulations Policy and Management, Office of General Counsel, Department of Veterans Affairs. [FR Doc. 2013–02024 Filed 1–30–13; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0775] Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program) Activity: Comment Request Veterans Health Administration, Department of Veterans Affairs ACTION: Notice. AGENCY: In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501–3521), this notice announces that the Veterans Health Administration, 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 March 4, 2013. ADDRESSES: Submit written comments on the collection of information through www.Regulations.gov; or to VA’s OMB Desk Officer, OMB Human Resources srobinson on DSK4SPTVN1PROD with SUMMARY: VerDate Mar<15>2010 17:38 Jan 30, 2013 Jkt 229001 and Housing Branch, New Executive Office Building, Room 10235, Washington, DC 20503 (202) 395–7316. Please refer to ‘‘OMB Control No. 2900– 0775’’ in any correspondence. FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202)632– 7492, FAX (202) 632–7583 or email crystal.rennie@va.gov. Please refer to ‘‘OMB Control No. 2900–0775.’’ SUPPLEMENTARY INFORMATION: Title: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10–0476. OMB Control Number: 2900–0775. Type of Review: Extension of a currently approved collection. Abstract: VA Form 10–0476 will be used to gather feedback from patients regarding their satisfaction with the quality of services/care provided by home care program staff. 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 November 19, 2012, at page 69550. Estimated Annual Burden: 17 hours. Estimated Average Burden per Respondent: 10 minutes. Frequency of Response: On occasion. Estimated Number of Respondents: 50. Estimated Number of Responses: 100. Dated: January 25, 2013. By direction of the Secretary. William F. Russo, Deputy Director, Office of Regulations Policy and Management, Office of General Counsel, Department of Veterans Affairs. [FR Doc. 2013–02034 Filed 1–30–13; 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 Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501–3521), this notice SUMMARY: PO 00000 Frm 00049 Fmt 4703 Sfmt 4703 6851 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. DATES: Comments must be submitted on or before March 4, 2013. ADDRESSES: Submit written comments on the collection of information through 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: Crystal Rennie, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632– 7492, fax (202) 632–7583 or email crystal.rennie@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 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 E:\FR\FM\31JAN1.SGM 31JAN1 6852 Federal Register / Vol. 78, No. 21 / Thursday, January 31, 2013 / Notices soliciting comments on this collection of information was published on November 19, 2012, on pages 69550– 69551. 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: January 25, 2013. By direction of the Secretary. William F. Russo, Deputy Director, Office of Regulations Policy and Management, Office of General Counsel, Department of Veterans Affairs. [FR Doc. 2013–02028 Filed 1–30–13; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0518] Agency Information Collection (Income Verification) 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 March 4, 2013. ADDRESSES: Submit written comments on the collection of information through 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– 0518’’ in any correspondence. FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632– 7492, FAX (202) 632–7583 or email crystal.rennie@va.gov. Please refer to ‘‘OMB Control No. 2900–0518.’’ srobinson on DSK4SPTVN1PROD with SUMMARY: VerDate Mar<15>2010 17:38 Jan 30, 2013 Jkt 229001 SUPPLEMENTARY INFORMATION: Dated: January 25, 2013. By direction of the Secretary. William F. Russo, Deputy Director, Office of Regulations Policy and Management, Office of General Counsel, Department of Veterans Affairs. [FR Doc. 2013–02035 Filed 1–30–13; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0465] Agency Information Collection (Student Verification of Enrollment) 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 March 4, 2013. SUMMARY: PO 00000 Frm 00050 Fmt 4703 Sfmt 9990 Submit written comments on the collection of information through 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– 0465’’ in any correspondence. ADDRESSES: Title: Income Verification, VA Form 21–0161a. OMB Control Number: 2900–0518. Type of Review: Extension of a currently approved collection. Abstract: VA Form 21–0161a is completed by employers of beneficiaries who have been identified as having inaccurately reported their income to VA. The data collected is used to determine the beneficiary’s entitlement to income dependent 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 October 22, 2012, at pages 64596–64597. Affected Public: Business or other forprofit. Estimated Annual Burden: 15,000 hours. Frequency of Response: One time. Estimated Number of Respondents: 30 minutes. Estimated Annual Responses: 30,000. FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632– 7492, FAX (202) 632–7583 or email crystal.rennie@va.gov. Please refer to ‘‘OMB Control No. 2900–0465.’’ SUPPLEMENTARY INFORMATION: Title: Student Verification of Enrollment, VA Form 22–8979. OMB Control Number: 2900–0465. Type of Review: Extension of a currently approved collection. Abstract: VA Form 22–8979 contains a student’s certification of actual attendance and verification of the student’s continued enrollment in courses leading to a standard college degree or in non-college degree programs. VA uses the data collected to determine the student’s continued entitlement to benefits. Students are required to submit verification on a monthly basis to allow for a frequent, periodic release 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 November 13, 2012, at pages 67737– 67738. Affected Public: Individuals or households. Estimated Annual Burden: 42,313 hours. Estimated Average Burden per Respondent: 1 minute. Frequency of Response: On occasion. Estimated Number of Respondents: 362,684. Estimated Number of Responses: 2,538,788. Dated: January 25, 2013. By direction of the Secretary. William F. Russo, Deputy Director, Office of Regulations Policy and Management, Office of General Counsel, Department of Veterans Affairs. [FR Doc. 2013–02027 Filed 1–30–13; 8:45 am] BILLING CODE 8320–01–P E:\FR\FM\31JAN1.SGM 31JAN1

Agencies

[Federal Register Volume 78, Number 21 (Thursday, January 31, 2013)]
[Notices]
[Pages 6851-6852]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-02028]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0335]


Agency Information Collection (Dental Record Authorization and 
Invoice for Outpatient Services) Activity 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.

DATES: Comments must be submitted on or before March 4, 2013.

ADDRESSES: Submit written comments on the collection of information 
through 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: Crystal Rennie, Enterprise Records 
Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue 
NW., Washington, DC 20420, (202) 632-7492, fax (202) 632-7583 or email 
crystal.rennie@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 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

[[Page 6852]]

soliciting comments on this collection of information was published on 
November 19, 2012, on pages 69550-69551.
    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: January 25, 2013.

    By direction of the Secretary.
William F. Russo,
Deputy Director, Office of Regulations Policy and Management, Office of 
General Counsel, Department of Veterans Affairs.
[FR Doc. 2013-02028 Filed 1-30-13; 8:45 am]
BILLING CODE 8320-01-P