Agency Information Collection (Application for Automobile or other Conveyance and Adaptive Equipment): Activity Under OMB Review, 58867-58868 [2014-23259]

Download as PDF Federal Register / Vol. 79, No. 189 / Tuesday, September 30, 2014 / Notices Dated: September 24, 2014. Richard A. Peterson, Deputy Director, United States Mint. [FR Doc. 2014–23273 Filed 9–29–14; 8:45 am] BILLING CODE P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0779] Agency Information Collection (Disability Benefits Questionnaires— Group 1) 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 October 30, 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. 2900–0779’’ 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– 0779.’’ SUPPLEMENTARY INFORMATION: Titles: a. Hematologic and Lymphatic Conditions, Including Leukemia Disability Benefits Questionnaire, VA Form 21–0960B–2. b. Amyotrophic Lateral Sclerosis (Lou Gehrig’s Disease) Disability Benefits Questionnaire, VA Form 21–0960C–2. c. Peripheral Nerve Conditions (Not Including Diabetic Sensory-Motor Peripheral Neuropathy) Disability Benefits Questionnaire, VA Form 21– 0960C–10. tkelley on DSK3SPTVN1PROD with NOTICES SUMMARY: VerDate Sep<11>2014 18:09 Sep 29, 2014 Jkt 232001 d. Persian Gulf and Afghanistan Infectious Diseases Disability Benefits Questionnaire, VA Form 21–0960I–1. e. Tuberculosis Disability Benefits Questionnaire, VA Form 21–0960I–6. f. Kidney Conditions (Nephrology) Disability Benefits Questionnaire, VA Form 21–0960J–1. g. Male Reproductive Organ Conditions Disability Benefits Questionnaire, VA Form 21–0960J–2. h. Prostate Cancer Disability Benefits Questionnaire, VA Form 21–0960J–3. l. Eating Disorders Disability Benefits Questionnaire, VA Form 21–0960P–1. m. Mental Disorders (other than PTSD and Eating Disorders) Disability Benefits Questionnaire, VA Form 21–0960P–2. n. Review Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire, VA Form 21–0960P–3. OMB Control Number: 2900–0779. Type of Review: Revision. Abstract: Data collected on VA Form 21–0960 series will be used obtain information from claimants treating physician that is necessary to adjudicate a claim for disability 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 July 17, 2014, at pages 41743–41744. Affected Public: Individuals or households. Estimated Annual Burden: 127, 917. Estimated Average Burden per Respondent: a. VA Form 21–0960B–2—15 minutes. (a) b. VA Form 21–0960C–2—30 minutes. (b) c. VA Form 21–0960C–10—45 minutes. (c) d. VA Form 21–0960I–1—15 minutes. (d) e. VA Form 21–0960I–6—30 minutes. (e) f. VA Form 21–0960J–1—30 minutes. (f) g. VA Form 21–0960J–2—15 minutes. (g) h. VA Form 21–0960J–3—15 minutes. (h) l. VA Form 21–0960P–1—15 minutes. (i) m. VA Form 21–0960P–2—30 minutes. (j) n. VA Form 21–0960P–3—30 minutes. Frequency of Response: On occasion. Estimated Number of Respondents: TOTAL: 307,000. a. VA Form 21–0960B–2—10,000. b. VA Form 21–0960C–2—2,000. c. VA Form 21–0960C–10—55,000. PO 00000 Frm 00143 Fmt 4703 Sfmt 4703 58867 d. VA Form 21–0960I–1—50,000. e. VA Form 21–0960I–6—5,000. f. VA Form 21–0960J–1—25,000. g. VA Form 21–0960J–2—25,000. h. VA Form 21–0960J–3—25,000. i. VA Form 21–0960M–13—50,000. j. VA Form 21–0960M–14—50,000. k. VA Form 21–0960O–1—25,000. l. VA Form 21–0960P–1—5,000. m. VA Form 21–0960P–2—50,000. n. VA Form 21–0960P–3—55,000. Dated: September 25, 2014. By direction of the Secretary: Crystal Rennie, Department Clearance Officer, Department of Veterans Affairs. [FR Doc. 2014–23272 Filed 9–29–14; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0067] Agency Information Collection (Application for Automobile or other Conveyance and Adaptive Equipment): 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 October 30, 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. 2900–0067’’ in any correspondence. SUMMARY: 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– 0067.’’ E:\FR\FM\30SEN1.SGM 30SEN1 58868 Federal Register / Vol. 79, No. 189 / Tuesday, September 30, 2014 / Notices DATES: SUPPLEMENTAL INFORMATION: Title: Application for Automobile or other Conveyance and Adaptive Equipment (under 38 U.S.C. 3901– 3904), VA Form 21–4502. OMB Control Number: 2900–0067. Type of Review: Revision of a currently approved collection. Abstract: Veterans, servicepersons and their survivors complete VA Form 21–4502 to apply for automobile or other conveyance allowance, and reimbursement for the cost and installation of adaptive equipment. VA uses the information to determine the claimant’s eligibility for such 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 June 12, 2014, at pages 33805 and 33806. Affected Public: Individuals or households. Estimated Annual Burden: 388. Estimated Average Burden per Respondent: 15 minutes. Frequency of Response: One–time. Estimated Number of Respondents: 1,552. Dated: September 25, 2014. By direction of the Secretary: Crystal Rennie, Department Clearance Officer, Department of Veterans Affairs. [FR Doc. 2014–23259 Filed 9–29–14; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0075] Agency Information Collection (Statement in Support of Claim) 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. tkelley on DSK3SPTVN1PROD with NOTICES SUMMARY: VerDate Sep<11>2014 18:09 Sep 29, 2014 Jkt 232001 Comments must be submitted on or before October 30, 2014. DEPARTMENT OF VETERANS AFFAIRS 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. 2900–0075’’ in any correspondence. [OMB Control No. 2900–0107] ADDRESSES: 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– 0075.’’ SUPPLEMENTARY INFORMATION: Title: Statement in Support of Claim, VA Form 21–4138. OMB Control Number: 2900–0075. Type of Review: Revision of a currently approved collection. Abstract: Statements submitted by or on behalf of a claimant must contain a certification by the respondent that the information provided to VA is true and correct in support of various types of benefit claims processed by VA. VA Form 21–4138 is to used collect the statement in support of such claims. 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 July 17, 2014, at page 41744. Affected Public: Individuals or households. Estimated Annual Burden: 188,000 hours. Estimated Average Burden per Respondent: 15 minutes. Frequency of Response: On occasion. Estimated Number of Respondents: 752,000. Dated: September 25, 2014. By direction of the Secretary: Crystal Rennie, Department Clearance Officer, Department of Veterans Affairs. [FR Doc. 2014–23260 Filed 9–29–14; 8:45 am] BILLING CODE 8320–01–P PO 00000 Frm 00144 Fmt 4703 Sfmt 4703 Agency Information Collection (Certificate as to Assets) Activities 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 October 30, 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. 2900–0107’’ 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– 0107.’’ SUPPLEMENTARY INFORMATION: Title: Certificate as to Assets, VA Form 21P–4709. OMB Control Number: 2900–0107. Type of Review: Revision of a currently approved collection. Abstract: Fiduciaries are required to complete VA Form 21P4709 to report investment in savings, bonds and other securities that he or she received on behalf of beneficiaries who are incompetent or under legal disability. Estate analysts employed by VA use the data collected to verify the fiduciaries accounting of a beneficiary’s estate. 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 SUMMARY: E:\FR\FM\30SEN1.SGM 30SEN1

Agencies

[Federal Register Volume 79, Number 189 (Tuesday, September 30, 2014)]
[Notices]
[Pages 58867-58868]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-23259]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0067]


Agency Information Collection (Application for Automobile or 
other Conveyance and Adaptive Equipment): 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 30, 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. 
2900-0067'' 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. 2900-0067.''

[[Page 58868]]


SUPPLEMENTAL INFORMATION:
    Title: Application for Automobile or other Conveyance and Adaptive 
Equipment (under 38 U.S.C. 3901-3904), VA Form 21-4502.
    OMB Control Number: 2900-0067.
    Type of Review: Revision of a currently approved collection.
    Abstract: Veterans, servicepersons and their survivors complete VA 
Form 21-4502 to apply for automobile or other conveyance allowance, and 
reimbursement for the cost and installation of adaptive equipment. VA 
uses the information to determine the claimant's eligibility for such 
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 June 12, 2014, at pages 33805 and 33806.
    Affected Public: Individuals or households.
    Estimated Annual Burden: 388.
    Estimated Average Burden per Respondent: 15 minutes.
    Frequency of Response: One-time.
    Estimated Number of Respondents: 1,552.

    Dated: September 25, 2014.

    By direction of the Secretary:
Crystal Rennie,
Department Clearance Officer, Department of Veterans Affairs.
[FR Doc. 2014-23259 Filed 9-29-14; 8:45 am]
BILLING CODE 8320-01-P
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