Agency Information Collection Activity Under OMB Review: (Supportive Services for Veteran Families (SSVF) Program Application for Supportive Services Grant), 8972-8973 [2017-02078]
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8972
Federal Register / Vol. 82, No. 20 / Wednesday, February 1, 2017 / Notices
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:
1. Enrollment Application for VA
Health Care—VA Form 10–10EZ.
2. Application for Renewal of Health
Care Benefits—VA Form 10–10EZR.
3. Request for Hardship
Determination—VA Form 10–10HS.
OMB Control Number: 2900–0091.
Type of Review: Revision of a
currently approved collection.
Abstracts:
a. VA Form 10–10EZ collects
information only from new applicants
for VA medical care, nursing home,
domiciliary, dental benefits, and new
enrollees in the VA health care system.
b. VA Form 10–10EZR, Health
Benefits Renewal Form, is used to
collect data from those veterans who
wish to update their application data.
c. VA Form 10–10HS collects
information only from veterans who are
in a copay required status for hospital
care and medical services, but due to a
loss of income project their income for
the current year will be substantially
below the VA means test limits.
Affected Public: Individuals or
households.
Estimated Annual Burden:
a. Enrollment Application for VA
Health Care—VA Form 10–10EZ—
270,000 hours.
b. Application for Renewal of Health
Care Benefits—VA Form 10–10EZR—
343,600 hours.
c. Request for Hardship
Determination—VA Form 10–10HS—
1,750 hours.
Estimated Average Burden per
Respondent:
a. Enrollment Application for VA
Health Care—VA Form 10–10EZ—30
minutes.
b. Application for Renewal of Health
Care Benefits—VA Form 10–10EZR—24
minutes.
c. Request for Hardship
Determination—VA Form 10–10HS—15
minutes.
Frequency of Response: Annually.
VerDate Sep<11>2014
16:23 Jan 31, 2017
Jkt 241001
Estimated Annual Responses:
a. Enrollment Application for VA
Health Care—VA Form 10–10EZ—
540,000.
b. Application for Renewal of Health
Care Benefits—VA Form 10–10EZR—
859,000.
c. Request for Hardship
Determination—VA Form 10–10HS—
7,000.
By direction of the Secretary.
Cynthia Harvey-Pryor,
Agency Clearance Officer, Office of Privacy
and Records Management, Department of
Veterans Affairs.
[FR Doc. 2017–02138 Filed 1–31–17; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0757]
Agency Information Collection Activity
Under OMB Review: (Supportive
Services for Veteran Families (SSVF)
Program Application for Supportive
Services Grant)
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 (VHA), 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.
SUMMARY:
Comments must be submitted on
or before March 3, 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. 2900–0757’’ in any
correspondence.
DATES:
FOR FURTHER INFORMATION CONTACT:
Brian McCarthy, Office of Regulatory
and Administrative Affairs (10B4)
Department of Veterans Affairs, 810
Vermont Avenue NW., Washington, DC
20420, (202) 461–6345 or email
PO 00000
Frm 00064
Fmt 4703
Sfmt 4703
brian.mccarthy4@va.gov. Please refer to
‘‘OMB Control No. 2900–0757, Proposed
Information Collection (Supportive
Services for Veteran Families (SSVF)
Program) Application For Supportive
Services Grant).
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. The 60-day Federal Register
Notice published on Monday, November
28, 2016, Vol. 81, Pages 85693–85694.
Title: Supportive Services for Veteran
Families (SSVF) Program.
a. Application for Supportive Services
Grants VA Form 10–10072.
b. Participant Satisfaction Survey, VA
Form 10–10072a.
c. Quarterly Grantee Performance
Report, VA Form 10–10072b.
d. Renewal Application. VA Form 10–
10072c.
e. Applicant Budget Template Excel
Worksheet.
f. FY16 Financial Report.
g. Grantee Certification.
OMB Control Number: 2900–0757
(Supportive Services for Veteran
Families (SSVF) Program).
Type of Review: Revision.
Abstract: The purpose of the
Supportive Services for Veteran
Families (SSVF) Program is to provide
supportive services grants to private
non-profit organizations and consumer
cooperatives who will coordinate or
provide supportive services to very lowincome veteran families who are
residing in permanent housing, are
homeless and scheduled to become
residents of permanent housing within
a specified time period, or after exiting
permanent housing, are seeking other
housing that is responsive to such very
low-income veteran family’s needs and
preferences.
E:\FR\FM\01FEN1.SGM
01FEN1
Federal Register / Vol. 82, No. 20 / Wednesday, February 1, 2017 / Notices
sradovich on DSK3GMQ082PROD with NOTICES
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.
Affected Public: Individuals or
households.
VerDate Sep<11>2014
16:23 Jan 31, 2017
Jkt 241001
Estimated Annual Burden: 25,505
hours.
Estimated Average Burden per
Respondent: 62.5 minutes.
Frequency of Response: One-time.
Estimated Number of Respondents:
12,270.
PO 00000
Frm 00065
Fmt 4703
Sfmt 9990
8973
By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Office of
Privacy and Records Management,
Department of Veterans Affairs.
[FR Doc. 2017–02078 Filed 1–31–17; 8:45 am]
BILLING CODE 8320–01–P
E:\FR\FM\01FEN1.SGM
01FEN1
Agencies
[Federal Register Volume 82, Number 20 (Wednesday, February 1, 2017)]
[Notices]
[Pages 8972-8973]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-02078]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0757]
Agency Information Collection Activity Under OMB Review:
(Supportive Services for Veteran Families (SSVF) Program Application
for Supportive Services Grant)
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, 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 March 3, 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-
0757'' in any correspondence.
FOR FURTHER INFORMATION CONTACT: Brian McCarthy, Office of Regulatory
and Administrative Affairs (10B4) Department of Veterans Affairs, 810
Vermont Avenue NW., Washington, DC 20420, (202) 461-6345 or email
brian.mccarthy4@va.gov. Please refer to ``OMB Control No. 2900-0757,
Proposed Information Collection (Supportive Services for Veteran
Families (SSVF) Program) Application For Supportive Services Grant).
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. The 60-day Federal Register Notice published on
Monday, November 28, 2016, Vol. 81, Pages 85693-85694.
Title: Supportive Services for Veteran Families (SSVF) Program.
a. Application for Supportive Services Grants VA Form 10-10072.
b. Participant Satisfaction Survey, VA Form 10-10072a.
c. Quarterly Grantee Performance Report, VA Form 10-10072b.
d. Renewal Application. VA Form 10-10072c.
e. Applicant Budget Template Excel Worksheet.
f. FY16 Financial Report.
g. Grantee Certification.
OMB Control Number: 2900-0757 (Supportive Services for Veteran
Families (SSVF) Program).
Type of Review: Revision.
Abstract: The purpose of the Supportive Services for Veteran
Families (SSVF) Program is to provide supportive services grants to
private non-profit organizations and consumer cooperatives who will
coordinate or provide supportive services to very low-income veteran
families who are residing in permanent housing, are homeless and
scheduled to become residents of permanent housing within a specified
time period, or after exiting permanent housing, are seeking other
housing that is responsive to such very low-income veteran family's
needs and preferences.
[[Page 8973]]
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.
Affected Public: Individuals or households.
Estimated Annual Burden: 25,505 hours.
Estimated Average Burden per Respondent: 62.5 minutes.
Frequency of Response: One-time.
Estimated Number of Respondents: 12,270.
By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Office of Privacy and Records Management,
Department of Veterans Affairs.
[FR Doc. 2017-02078 Filed 1-31-17; 8:45 am]
BILLING CODE 8320-01-P