Agency Information Collection (Claim, Authorization and Invoice for Prosthetic Items and Services); Activity Under OMB Review, 58609-58610 [2013-23137]

Download as PDF Federal Register / Vol. 78, No. 185 / Tuesday, September 24, 2013 / Notices An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the collection of information displays a valid OMB control number. Books or records relating to a collection of information must be retained as long as their contents may become material in the administration of any internal revenue law. Generally, tax returns and tax return information are confidential, as required by 26 U.S.C. 6103. Request for Comments: Comments submitted in response to this notice will be summarized and/or included in the request for OMB approval. All comments will become a matter of public record. Comments are invited on: (a) Whether the collection of information is necessary for the proper performance of the functions of the agency, including whether the information shall have practical utility; (b) the accuracy of the agency’s estimate of the burden of the collection of information; (c) ways to enhance the quality, utility, and clarity of the information to be collected; (d) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques or other forms of information technology; and (e) estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to provide information. Approved: August 23, 2013. Allan M. Hopkins, Tax Analyst. [FR Doc. 2013–23121 Filed 9–23–13; 8:45 am] BILLING CODE 4830–01–P DEPARTMENT OF THE TREASURY Internal Revenue Service Proposed Collection; Comment Request for Regulation Project Internal Revenue Service (IRS), Treasury. ACTION: Notice and request for comments. AGENCY: The Department of the Treasury, as part of its continuing effort to reduce paperwork and respondent burden, invites the general public and other Federal agencies to take this opportunity to comment on proposed and/or continuing information collections, as required by the Paperwork Reduction Act of 1995, Public Law 104–13(44 U.S.C. 3506(c)(2)(A)). Currently, the IRS is soliciting comments concerning Designated Roth Contributions to Cash mstockstill on DSK4VPTVN1PROD with NOTICES SUMMARY: VerDate Mar<15>2010 21:43 Sep 23, 2013 Jkt 229001 or Deferred Arrangements Under Section 401(k). DATES: Written comments should be received on or before November 25, 2013 to be assured of consideration. ADDRESSES: Direct all written comments to Yvette B. Lawrence, Internal Revenue Service, Room 6129, 1111 Constitution Avenue NW., Washington, DC 20224. FOR FURTHER INFORMATION CONTACT: Requests for additional information or copies of the regulation should be directed to Gerald J. Shields, LL.M. at Internal Revenue Service, Room 6129, 1111 Constitution Avenue NW., Washington DC 20224 or through the Internet at Gerald.J.Shields@irs.gov. SUPPLEMENTARY INFORMATION: Title: Designated Roth Contributions to Cash or Deferred Arrangements Under Section 401(k). OMB Number: 1545–1931. Regulation Project Number: TD 9237 (REG–152354–04). Abstract: These regulations provide guidance concerning the requirements for designated Roth contributions to qualified cash or deferred arrangements under section 401(k). The IRS needs this information to insure compliance with section 401(k) and (m) and section 402A. Current Actions: There is no change to this existing regulation. Type of Review: Extension of a currently approved collection. Affected Public: Business or other forprofit organizations, not-for-profit institutions and state, local or tribal governments. Estimated Number of Respondents: 157,500. Estimated Time per Respondent: 1 hour. Estimated Total Annual Burden Hours: 157,500. The following paragraph applies to all of the collections of information covered by this notice: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the collection of information displays a valid OMB control number. Books or records relating to a collection of information must be retained as long as their contents may become material in the administration of any internal revenue law. Generally, tax returns and tax return information are confidential, as required by 26 U.S.C. 6103. Request for Comments: Comments submitted in response to this notice will be summarized and/or included in the request for OMB approval. All comments will become a matter of public record. Comments are invited on: PO 00000 Frm 00099 Fmt 4703 Sfmt 4703 58609 (a) Whether the collection of information is necessary for the proper performance of the functions of the agency, including whether the information shall have practical utility; (b) the accuracy of the agency’s estimate of the burden of the collection of information; (c) ways to enhance the quality, utility, and clarity of the information to be collected; (d) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques or other forms of information technology; and (e) estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to provide information. Approved: September 11, 2013. Allan M. Hopkins, Tax Analyst. [FR Doc. 2013–23122 Filed 9–23–13; 8:45 am] BILLING CODE 4830–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0188] Agency Information Collection (Claim, Authorization and Invoice for Prosthetic Items and 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 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 and includes the actual data collection instrument. DATES: Comments must be submitted on or before October 24, 2013. ADDRESSES: Submit written comments on the collection of information through www.Regulations.gov, or to Office of Information and Regulatory Affairs, Office of Management and Budget, Attn: VA Desk Officer; 725 17th St. NW., Washington, DC 20503 or sent through electronic mail to oira_submission@ omb.eop.gov. Please refer to ‘‘OMB Control No. 2900–0188’’ in any correspondence. SUMMARY: FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records E:\FR\FM\24SEN1.SGM 24SEN1 mstockstill on DSK4VPTVN1PROD with NOTICES 58610 Federal Register / Vol. 78, No. 185 / Tuesday, September 24, 2013 / Notices Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW,, Washington, DC 20420, (202) 632– 7492 or email crystal.rennie@va.gov. Please refer to ‘‘OMB Control No. 2900– 0188.’’ SUPPLEMENTARY INFORMATION: Titles: (a) Request to Submit Quotation, Form Letter 10–90. (b) Veterans Application for Assistance in Acquiring Home Improvement and Structural Alterations, VA Form 10–0103. (c) Application for Adaptive Equipment Motor Vehicle, VA Form 10– 1394. (d) Prosthetic Authorization for Items or Services, VA Form 10–2421. (e) Prosthetic Service Card Invoice, VA Form 10–2520. (f) Prescription and Authorization for Fee Basis Eyeglasses, VA Form 10–2914. OMB Control Number: 2900–0188. Type of Review: Revision of a currently approved collection. Abstract: The following forms will are used to determine eligibility, prescribe and authorize prosthetic devices: a. VA Form Letter 10–90 is used to obtain to estimated price for prosthetic devices. b. VA Form 10–0103 is used to determine eligibility/entitlement and reimbursement of individual claims for home improvement and structural alterations. c. VA Form 10–1394 is used to determine eligibility/entitlement and reimbursement of individual claims for automotive adaptive equipment. d. VA Form 10–2421 is used for the direct procurement of new prosthetic appliances and/or services. The form standardizes the direct procurement authorization process, eliminating the need for separate purchase orders, expedites patient treatment and improves the delivery of prosthetic services. e. VA Form 10–2520 is used by the vendors as an invoice and billing document. The form standardizes repair/treatment invoices for prosthetic services rendered and standardizes the verification of these invoices. The Veteran certifies that the repairs were necessary and satisfactory. This form is furnished to vendors upon request. f. VA Form 10–2914 is used as a combination prescription, authorization and invoice. It allows veterans to purchase their eyeglasses directly. If the form is not used, the provisions of providing eyeglasses to eligible Veterans may be delayed. An agency may not conduct or sponsor, and a person is not required to VerDate Mar<15>2010 21:43 Sep 23, 2013 Jkt 229001 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 June 11, 2013, at page 35099. Affected Public: Individuals or households. Estimated Total Annual Burden: 5,738. (a) Form Letter 10–90—708. (b) VA Form 10–0103—583. (c) VA Form 10–1394—1,000. (d) VA Form 10–2421—67. (e) VA Form 10–2520—47. (f) VA Form 10–2914—3,333. Estimated Average Burden Per Respondent: (a) Form Letter 10–90—5 minutes. (b) VA Form 10–0103—5 minutes. (c) VA Form 10–1394—15 minutes. (d) VA Form 10–2421—4 minutes. (e) VA Form 10–2520—4 minutes. (f) VA Form 10–2914—4 minutes. Frequency of Response: On occasion. Estimated Number of Respondents: 71,200. a. Form Letter 10–90—8,500. c. VA Form 10–0103—7,000. d. VA Form 10–1394—4,000. e. VA Form 10–2421—1,000. f. VA Form 10–2520—700. g. VA Form 10–2914—50,000. Dated: September 19, 2013. By direction of the Secretary. Crystal Rennie, VA Clearance Officer, U.S. Department of Veterans Affairs. [FR Doc. 2013–23137 Filed 9–23–13; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0261] Agency Information Collection (Application for Refund of Educational Contributions) 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 SUMMARY: PO 00000 Frm 00100 Fmt 4703 Sfmt 4703 its expected cost and burden; it includes the actual data collection instrument. DATES: Comments must be submitted on or before October 24, 2013. ADDRESSES: Submit written comments on the collection of information through www.Regulations.gov, or to Office of Information and Regulatory Affairs, Office of Management and Budget, Attn: VA Desk Officer; 725 17th St. NW., Washington, DC 20503 or sent through electronic mail to oira_submission@ omb.eop.gov. Please refer to ‘‘OMB Control No. 2900–0261’’ 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 or email crystal.rennie@va.gov. Please refer to ‘‘OMB Control No. 2900– 0261.’’ SUPPLEMENTARY INFORMATION: Title: Application for Refund of Educational Contributions (VEAP, Chapter 32, Title 38, U.S.C.), VA Form 22–5281. OMB Control Number: 2900–0261. Type of Review: Revision of a currently approved collection. Abstract: Veterans and service persons complete VA Form 22–5281 to request a refund of their contribution to the Post-Vietnam Veterans Education Program. Contribution made into the Post-Vietnam Veterans Education Program may be refunded only after the participant has disenrolled from the program. Request for refund of contribution prior to discharge or release from active duty will be refunded on the date of the participant’s discharge or release from activity duty or within 60 days of receipt of notice by the Secretary of the participant’s discharge or disenrollment. Refunds may be made earlier in instances of hardship or other good reasons. Participants who stop their enrollment from the program after discharge or release from active duty contributions will be refunded within 60 days of receipt of their application. 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 June 18, 2013 at page 36643. Affected Public: Individuals or households. Estimated Annual Burden: 85 hours. Estimated Average Burden per Respondent: 10 minutes. Frequency of Response: Annually. E:\FR\FM\24SEN1.SGM 24SEN1

Agencies

[Federal Register Volume 78, Number 185 (Tuesday, September 24, 2013)]
[Notices]
[Pages 58609-58610]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-23137]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0188]


Agency Information Collection (Claim, Authorization and Invoice 
for Prosthetic Items and 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, 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 includes the actual data collection instrument.

DATES:  Comments must be submitted on or before October 24, 2013.

ADDRESSES: Submit written comments on the collection of information 
through www.Regulations.gov, or to Office of Information and Regulatory 
Affairs, Office of Management and Budget, Attn: VA Desk Officer; 725 
17th St. NW., Washington, DC 20503 or sent through electronic mail to 
oira_submission@omb.eop.gov. Please refer to ``OMB Control No. 2900-
0188'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records

[[Page 58610]]

Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue 
NW,, Washington, DC 20420, (202) 632-7492 or email 
crystal.rennie@va.gov. Please refer to ``OMB Control No. 2900-0188.''

SUPPLEMENTARY INFORMATION:
    Titles:
    (a) Request to Submit Quotation, Form Letter 10-90.
    (b) Veterans Application for Assistance in Acquiring Home 
Improvement and Structural Alterations, VA Form 10-0103.
    (c) Application for Adaptive Equipment Motor Vehicle, VA Form 10-
1394.
    (d) Prosthetic Authorization for Items or Services, VA Form 10-
2421.
    (e) Prosthetic Service Card Invoice, VA Form 10-2520.
    (f) Prescription and Authorization for Fee Basis Eyeglasses, VA 
Form 10-2914.
    OMB Control Number: 2900-0188.
    Type of Review: Revision of a currently approved collection.
    Abstract: The following forms will are used to determine 
eligibility, prescribe and authorize prosthetic devices:
    a. VA Form Letter 10-90 is used to obtain to estimated price for 
prosthetic devices.
    b. VA Form 10-0103 is used to determine eligibility/entitlement and 
reimbursement of individual claims for home improvement and structural 
alterations.
    c. VA Form 10-1394 is used to determine eligibility/entitlement and 
reimbursement of individual claims for automotive adaptive equipment.
    d. VA Form 10-2421 is used for the direct procurement of new 
prosthetic appliances and/or services. The form standardizes the direct 
procurement authorization process, eliminating the need for separate 
purchase orders, expedites patient treatment and improves the delivery 
of prosthetic services.
    e. VA Form 10-2520 is used by the vendors as an invoice and billing 
document. The form standardizes repair/treatment invoices for 
prosthetic services rendered and standardizes the verification of these 
invoices. The Veteran certifies that the repairs were necessary and 
satisfactory. This form is furnished to vendors upon request.
    f. VA Form 10-2914 is used as a combination prescription, 
authorization and invoice. It allows veterans to purchase their 
eyeglasses directly. If the form is not used, the provisions of 
providing eyeglasses to eligible Veterans may be delayed.
    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 June 11, 2013, at page 35099.
    Affected Public: Individuals or households.
    Estimated Total Annual Burden: 5,738.
    (a) Form Letter 10-90--708.
    (b) VA Form 10-0103--583.
    (c) VA Form 10-1394--1,000.
    (d) VA Form 10-2421--67.
    (e) VA Form 10-2520--47.
    (f) VA Form 10-2914--3,333.
    Estimated Average Burden Per Respondent:
    (a) Form Letter 10-90--5 minutes.
    (b) VA Form 10-0103--5 minutes.
    (c) VA Form 10-1394--15 minutes.
    (d) VA Form 10-2421--4 minutes.
    (e) VA Form 10-2520--4 minutes.
    (f) VA Form 10-2914--4 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents: 71,200.
    a. Form Letter 10-90--8,500.
    c. VA Form 10-0103--7,000.
    d. VA Form 10-1394--4,000.
    e. VA Form 10-2421--1,000.
    f. VA Form 10-2520--700.
    g. VA Form 10-2914--50,000.

    Dated: September 19, 2013.

    By direction of the Secretary.
Crystal Rennie,
VA Clearance Officer, U.S. Department of Veterans Affairs.
[FR Doc. 2013-23137 Filed 9-23-13; 8:45 am]
BILLING CODE 8320-01-P