Agency Information Collection (Supplement to VA Forms 21-526, 21-534, and 21-535 (for Philippine Claims) (VA Form 21-4169) Activity Under OMB Review, 53116-53117 [2014-21149]

Download as PDF 53116 Federal Register / Vol. 79, No. 172 / Friday, September 5, 2014 / Notices 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. 2900–0629’’ in any correspondence. During the comment period, comments may be viewed online through the FDMS. 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– 0629’’ in any correspondence. 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. Title: Application for Extended Care Services, VA Form 10–10EC. OMB Control Number: 2900–0629. Type of Review: Revision of a currently approved collection. Abstract: Title 38 U.S.C. Chapter 17 authorizes VA to provide hospital care, medical services, domiciliary care and nursing home care to eligible Veterans. Title 38 U.S.C. 1705 requires VA to design, establish and operate a system of annual patient enrollment in accordance with a series of stipulated priorities. A consequence of this is that many groups of Veterans who are in a lower priority group may request that they be allowed to be income tested in order to gain a higher priority. Title 38 U.S.C. 1722 establishes eligibility assessment procedures for cost-free VA medical rmajette on DSK2TPTVN1PROD with NOTICES ADDRESSES: VerDate Mar<15>2010 14:29 Sep 04, 2014 Jkt 232001 care, based on income levels, which will determine whether nonserviceconnected and 0% service-connected noncompensable Veterans are able to defray the necessary expenses of care for nonservice-connected conditions. Title 38 U.S.C. 1722A establishes the eligibility assessment procedures, based on income levels, for determining Veterans’ eligibility for cost-free medications and Title 38 U.S.C. 1710B defines the procedures for establishing eligibility for cost-free Extended Care benefits. Title 38 U.S.C. 1729 authorizes VA to recover from Veterans’ health insurance carriers the cost of care furnished for their nonserviceconnected conditions. VA Form 10–10EC, Application for Extended Care Services, is used to collect financial information necessary to determine a Veteran’s copayment obligation for extended care services, also known as long term care (LTC). VA Form 10–10EC, Application for Extended Care Services collects information to establish eligibility for extended care benefits, establishes financial liability Veteran to pay if accepted for placement in Extended Care Services, and establishes veteran has agreed to make any applicable copayment. Affected Public: Individuals or Households. Estimated Total Annual Burden: 3,000 hours. Estimated Average Burden per Respondent: 90 minutes. Frequency of Response: Yearly. Estimated Number of Respondents: 2,000. Dated: September 2, 2014. By direction of the Secretary. Crystal Rennie, VA Clearance Officer, U.S. Department of Veterans Affairs. [FR Doc. 2014–21148 Filed 9–4–14; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0094] Agency Information Collection (Supplement to VA Forms 21–526, 21– 534, and 21–535 (for Philippine Claims) (VA Form 21–4169) 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: PO 00000 Frm 00102 Fmt 4703 Sfmt 4703 (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 October 6, 2014. 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. 2900–0094’’ 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– 0094.’’ SUPPLEMENTARY INFORMATION: Title: Supplement to VA Forms 21– 526, 21–534, and 21–535 (for Philippine Claims), VA Form 21–4169. OMB Control Number: 2900–0094. Type of Review: Revision of a currently approved collection. Abstract: VA Form 21–4169 is used to collect certain applicants’ service information, place of residence, proof of service, and whether the applicant was a member of pro-Japanese, pro-German, or anti-American Filipino organizations. VA uses the information collected to determine the applicant’s eligibility for benefits based on Commonwealth Army of the Philippines or recognized guerrilla services. 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 12, 2014, at page 33812–33813. Affected Public: Individuals or households. Estimated Annual Burden: 250 hours. Estimated Average Burden per Respondent: 15 minutes. Frequency of Response: One-time. Estimated Number of Respondents: 1,000. Dated: September 2, 2014. E:\FR\FM\05SEN1.SGM 05SEN1 Federal Register / Vol. 79, No. 172 / Friday, September 5, 2014 / Notices By direction of the Secretary. Crystal Rennie, Department Clearance Officer, Department of Veterans Affairs. [FR Doc. 2014–21149 Filed 9–4–14; 8:45 am] rmajette on DSK2TPTVN1PROD with NOTICES BILLING CODE 8320–01–P VerDate Mar<15>2010 14:29 Sep 04, 2014 Jkt 232001 PO 00000 Frm 00103 Fmt 4703 Sfmt 9990 E:\FR\FM\05SEN1.SGM 05SEN1 53117

Agencies

[Federal Register Volume 79, Number 172 (Friday, September 5, 2014)]
[Notices]
[Pages 53116-53117]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-21149]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0094]


Agency Information Collection (Supplement to VA Forms 21-526, 21-
534, and 21-535 (for Philippine Claims) (VA Form 21-4169) 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 October 6, 2014.

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 
oirasubmission@omb.eop.gov. Please refer to ``OMB Control No. 
2900-0094'' 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. 2900-0094.''

SUPPLEMENTARY INFORMATION: 
    Title: Supplement to VA Forms 21-526, 21-534, and 21-535 (for 
Philippine Claims), VA Form 21-4169.
    OMB Control Number: 2900-0094.
    Type of Review: Revision of a currently approved collection.
    Abstract: VA Form 21-4169 is used to collect certain applicants' 
service information, place of residence, proof of service, and whether 
the applicant was a member of pro-Japanese, pro-German, or anti-
American Filipino organizations. VA uses the information collected to 
determine the applicant's eligibility for benefits based on 
Commonwealth Army of the Philippines or recognized guerrilla services.
    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 12, 2014, at page 33812-33813.
    Affected Public: Individuals or households.
    Estimated Annual Burden: 250 hours.
    Estimated Average Burden per Respondent: 15 minutes.
    Frequency of Response: One-time.
    Estimated Number of Respondents: 1,000.

    Dated: September 2, 2014.


[[Page 53117]]


By direction of the Secretary.
Crystal Rennie,
Department Clearance Officer, Department of Veterans Affairs.
[FR Doc. 2014-21149 Filed 9-4-14; 8:45 am]
BILLING CODE 8320-01-P