Proposed Information Collection Activity: (Income Verification), 8566-8567 [2017-01753]

Download as PDF 8566 Federal Register / Vol. 82, No. 16 / Thursday, January 26, 2017 / Notices By direction of the Secretary. Cynthia Harvey-Pryor, Agency Clearance Officer, Office of Privacy and Records Management, Department of Veterans Affairs. [FR Doc. 2017–01750 Filed 1–25–17; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0847] Agency Information Collection Activity Under OMB Review: Submission of School Catalog to the State Approving Agency 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 Office of Policy and Planning (OPP), 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. The Federal Register Notice with a 60day comment period soliciting comments on this collection of information was published on November 3, 2016, Vol. 81, page 76699. DATES: Comments must be submitted on or before February 27, 2017. 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. 2900–0847’’ in any correspondence. SUMMARY: jstallworth on DSK7TPTVN1PROD with NOTICES FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 461–5870 or email cynthia.harveypryor@va.gov. Please refer to ‘‘OMB Control No. 2900–0847.’’ SUPPLEMENTARY INFORMATION: Title: Veterans Employment Pay For Success (VEPFS), Grant Program Application. OMB Control Number: 2900–0847. VerDate Sep<11>2014 15:10 Jan 25, 2017 Jkt 241001 Type of Review: Extension of an approved collection. Abstract: Section 3119 of title 38, United States Code, authorizes the Secretary of Veterans Affairs to make grants to or contract with public or nonprofit agencies, including institutions of higher learning, to advance ‘‘the knowledge, methods, techniques, and resources available for use in rehabilitation programs for veterans.’’ Section 3119 specifically authorizes the Secretary to make grants to such agencies to conduct or provide support for projects which are ‘‘designed to increase the resources and potential for accomplishing the rehabilitation of disabled veterans.’’ VA has codified these provisions in its regulations at 38 CFR 21.390 Rehabilitation research and special projects. The purpose of the VEPFS program is to provide one or more grants to fund Outcomes Payments for one or more PFS projects that seek to improve employment outcomes for Veterans with a Service-connected Mental Health Disability. Affected Public: Individuals or households. Estimated Annual Burden: 2000 hours. Estimated Average Burden Per Respondent: 80 minutes. Frequency of Response: On occasion. Estimated Number of Respondents: 25. By direction of the Secretary. Cynthia Harvey-Pryor, VA Clearance Officer, Office of Privacy and Records Management, Department of Veterans Affairs. [FR Doc. 2017–01743 Filed 1–25–17; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–NEW] Proposed Information Collection Activity: (Income Verification) Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: The Veterans Health Administration (VHA) 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 this new SUMMARY: PO 00000 Frm 00064 Fmt 4703 Sfmt 4703 collection, and allow 60 days for public comment in response to the notice. This notice solicits comments on information needed to identify areas for improvement in clinical training programs. DATES: Written comments and recommendations on the proposed collection of information should be received on or before March 27, 2017. ADDRESSES: Submit written comments on the collection of information through the Federal Docket Management System (FDMS) at www.Regulations.gov; or to Brian McCarthy, Office of Regulatory and Administrative Affairs, Veterans Health Administration (10B4), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420 or email: Brian.McCarthy4@ va.gov. Please refer to ‘‘OMB Control No. 2900–NEW’’ in any correspondence. During the comment period, comments may be viewed online through FDMS. FOR FURTHER INFORMATION CONTACT: Brian McCarthy at (202) 461–6345. SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104–13; 44 U.S.C. 3501–3521), Federal agencies must obtain approval from 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. Mailed with Veterans’ Initial Letters—HEC Form 200–1A b. Mailed with Spouses’ Initial Letters—HEC Form 220–1 c. Mailed to Veterans When Necessary—HEC Form 340–1 d. Mailed to Veterans When Necessary—Checklist. OMB Control Number: 2900–NEW. Type of Review: New collection. Abstract: The HEC, IVD uses HEC Form 200–1A (Veteran’s Income Verification Response) to collect income verification information, as applicable, from the Veteran by requesting the E:\FR\FM\26JAN1.SGM 26JAN1 jstallworth on DSK7TPTVN1PROD with NOTICES Federal Register / Vol. 82, No. 16 / Thursday, January 26, 2017 / Notices Veteran to verify the listed income on the form as reported to IVD by IRS/SSA, to select the appropriate option on the form relating to the household income, attest to out of pocket medical expenses, attest to sale of primary home real estate and attest to separation from spouse for the income year under the Income Verification Division’s review. The Veteran’s signature is required on page 2 of HEC Form 200–1A. If the Veteran has medical/health limitations that does not enable the Veteran to physically sign the form with a wet signature, the Veteran must mark an ‘‘X’’ to designate a signature; two witnesses must verify the ‘‘X’’ as the Veteran’s signature. HEC, IVD will use the completed HEC Form 200–1A to assist in verifying the Veteran’s correct gross household income to ensure the Veteran is placed in the correct priority group for health care. The HEC, IVD uses HEC Form 220–1 (Spouse’s Income Verification Response) to collect income verification information, as applicable, from the Veteran’s spouse by requesting the spouse to verify the listed income on the form as reported to IVD by IRS/SSA, report any additional income not reported by IRS/SSA and sign and date the form. If the spouse has medical/ health limitations that does not enable the spouse to physically sign the form with a wet signature, the spouse must mark an ‘‘X’’ to designate a signature; two witnesses must verify the ‘‘X’’ as the Veteran’s signature. HEC, IVD will use the completed HEC Form 220–1 to assist in verifying the Veteran’s correct gross household income to ensure the Veteran is placed in the correct priority group for health care. The HEC, IVD uses the HEC Form 340–1 (Declaration of Representative) for the Veteran and the spouse (if applicable) to appoint a representative, authorizing HEC, IVD to release information to a designated appointee for a specific income year. Such information includes confidential federal tax information, other income, and medical benefits eligibility related information. The Veteran and spouse (if applicable) must sign and date the form. The HEC, IVD uses the HEC Income Verification—Additional Information Checklist to request from the Veteran any additional information needed to adjudicate the Income Verification case. The Veteran providing the requested information usually results in the best interest to the Veteran. Affected Public: Individuals or households. Estimated Annual Burden: VerDate Sep<11>2014 15:10 Jan 25, 2017 Jkt 241001 a. Mailed with Veterans’ Initial Letters—HEC Form 200–1A—89,001 hours b. Mailed with Spouses’ Initial Letters—HEC Form 220–1—28,530 hours c. Mailed to Veterans When Necessary—HEC Form 340–1—1,701 hours d. Mailed to Veterans When Necessary—Checklist—761 hours Estimated Average Burden per Respondent: a. Mailed with Veterans’ Initial Letters—HEC Form 200–1A—30 minutes b. Mailed with Spouses’ Initial Letters—HEC Form 220–1—20 minutes c. Mailed to Veterans When Necessary—HEC Form 340–1—15 minutes d. Mailed to Veterans When Necessary—Checklist—761—15 minutes Frequency of Response: Annually. Estimated Annual Responses: a. Mailed with Veterans’ Initial Letters—HEC Form 200–1A—178,002 b. Mailed with Spouses’ Initial Letters—HEC Form 220–1—85,590 c. Mailed to Veterans When Necessary—HEC Form 340–1—6,805 d. Mailed to Veterans When Necessary—Checklist—761—3,044 By direction of the Secretary. Cynthia Harvey-Pryor, Program Specialist, Office of Privacy and Records Management, Department of Veterans Affairs. [FR Doc. 2017–01753 Filed 1–25–17; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0342] Agency Information Collection Activity: (Application and Training Agreement for Apprenticeship and Onthe-Job Training Programs) (VA Form 22–8864; 22–8865)) Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: 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 SUMMARY: PO 00000 Frm 00065 Fmt 4703 Sfmt 4703 8567 extension of a currently approved collection, and allow 60 days for public comment in response to the notice. This notice solicits comments on information needed to determine that training programs (Apprenticeship and On-theJob Training) and agreements meet the statutory requirements for approval. DATES: Written comments and recommendations on the proposed collection of information should be received on or before March 27, 2017. 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. 2900–0342’’ in any correspondence. During the comment period, comments may be viewed online through the FDMS. FOR FURTHER INFORMATION CONTACT: Nancy J. Kessinger at (202) 632–8924 or FAX (202) 632–8925. SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104–13; 44 U.S.C. 3501–21), 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. Title: Application and Training Agreement for Apprenticeship and Onthe-Job Training Programs, VA Form 22–8864; 22–8865. OMB Control Number: 2900–0342. Type of Review: Revision of a currently approved collection. Abstract: VA Forms 22–8864 and 22– 8865 are used to collect information from employers and trainees to ensure that training programs (Apprenticeship and On-the-Job Training) and E:\FR\FM\26JAN1.SGM 26JAN1

Agencies

[Federal Register Volume 82, Number 16 (Thursday, January 26, 2017)]
[Notices]
[Pages 8566-8567]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-01753]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-NEW]


Proposed Information Collection Activity: (Income Verification)

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: The Veterans Health Administration (VHA) 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 
this new collection, and allow 60 days for public comment in response 
to the notice. This notice solicits comments on information needed to 
identify areas for improvement in clinical training programs.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before March 27, 2017.

ADDRESSES: Submit written comments on the collection of information 
through the Federal Docket Management System (FDMS) at 
www.Regulations.gov; or to Brian McCarthy, Office of Regulatory and 
Administrative Affairs, Veterans Health Administration (10B4), 
Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 
20420 or email: Brian.McCarthy4@va.gov. Please refer to ``OMB Control 
No. 2900-NEW'' in any correspondence. During the comment period, 
comments may be viewed online through FDMS.

FOR FURTHER INFORMATION CONTACT: Brian McCarthy at (202) 461-6345.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 
U.S.C. 3501-3521), Federal agencies must obtain approval from 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. Mailed with Veterans' Initial Letters--HEC Form 200-1A
    b. Mailed with Spouses' Initial Letters--HEC Form 220-1
    c. Mailed to Veterans When Necessary--HEC Form 340-1
    d. Mailed to Veterans When Necessary--Checklist.
    OMB Control Number: 2900-NEW.
    Type of Review: New collection.
    Abstract: The HEC, IVD uses HEC Form 200-1A (Veteran's Income 
Verification Response) to collect income verification information, as 
applicable, from the Veteran by requesting the

[[Page 8567]]

Veteran to verify the listed income on the form as reported to IVD by 
IRS/SSA, to select the appropriate option on the form relating to the 
household income, attest to out of pocket medical expenses, attest to 
sale of primary home real estate and attest to separation from spouse 
for the income year under the Income Verification Division's review. 
The Veteran's signature is required on page 2 of HEC Form 200-1A. If 
the Veteran has medical/health limitations that does not enable the 
Veteran to physically sign the form with a wet signature, the Veteran 
must mark an ``X'' to designate a signature; two witnesses must verify 
the ``X'' as the Veteran's signature. HEC, IVD will use the completed 
HEC Form 200-1A to assist in verifying the Veteran's correct gross 
household income to ensure the Veteran is placed in the correct 
priority group for health care.
    The HEC, IVD uses HEC Form 220-1 (Spouse's Income Verification 
Response) to collect income verification information, as applicable, 
from the Veteran's spouse by requesting the spouse to verify the listed 
income on the form as reported to IVD by IRS/SSA, report any additional 
income not reported by IRS/SSA and sign and date the form. If the 
spouse has medical/health limitations that does not enable the spouse 
to physically sign the form with a wet signature, the spouse must mark 
an ``X'' to designate a signature; two witnesses must verify the ``X'' 
as the Veteran's signature. HEC, IVD will use the completed HEC Form 
220-1 to assist in verifying the Veteran's correct gross household 
income to ensure the Veteran is placed in the correct priority group 
for health care.
    The HEC, IVD uses the HEC Form 340-1 (Declaration of 
Representative) for the Veteran and the spouse (if applicable) to 
appoint a representative, authorizing HEC, IVD to release information 
to a designated appointee for a specific income year. Such information 
includes confidential federal tax information, other income, and 
medical benefits eligibility related information. The Veteran and 
spouse (if applicable) must sign and date the form.
    The HEC, IVD uses the HEC Income Verification--Additional 
Information Checklist to request from the Veteran any additional 
information needed to adjudicate the Income Verification case. The 
Veteran providing the requested information usually results in the best 
interest to the Veteran.
    Affected Public: Individuals or households.
    Estimated Annual Burden:
    a. Mailed with Veterans' Initial Letters--HEC Form 200-1A--89,001 
hours
    b. Mailed with Spouses' Initial Letters--HEC Form 220-1--28,530 
hours
    c. Mailed to Veterans When Necessary--HEC Form 340-1--1,701 hours
    d. Mailed to Veterans When Necessary--Checklist--761 hours
    Estimated Average Burden per Respondent:
    a. Mailed with Veterans' Initial Letters--HEC Form 200-1A--30 
minutes
    b. Mailed with Spouses' Initial Letters--HEC Form 220-1--20 minutes
    c. Mailed to Veterans When Necessary--HEC Form 340-1--15 minutes
    d. Mailed to Veterans When Necessary--Checklist--761--15 minutes
    Frequency of Response: Annually.
    Estimated Annual Responses:
    a. Mailed with Veterans' Initial Letters--HEC Form 200-1A--178,002
    b. Mailed with Spouses' Initial Letters--HEC Form 220-1--85,590
    c. Mailed to Veterans When Necessary--HEC Form 340-1--6,805
    d. Mailed to Veterans When Necessary--Checklist--761--3,044

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Program Specialist, Office of Privacy and Records Management, 
Department of Veterans Affairs.
[FR Doc. 2017-01753 Filed 1-25-17; 8:45 am]
 BILLING CODE 8320-01-P