Agency Information Collection Activity: Request for and Consent to Release of Information From Claimant's Records, 16088-16089 [2017-06350]

Download as PDF 16088 Federal Register / Vol. 82, No. 61 / Friday, March 31, 2017 / Notices By direction of the Secretary. Cynthia Harvey-Pryor, Department Clearance Officer, Office of Privacy and Records Management, Department of Veterans Affairs. [FR Doc. 2017–06348 Filed 3–30–17; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0802] Agency Information Collection Activity Under OMB Review: Shoulder and Arm Conditions Disability Benefits Questionnaire Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: In compliance with the Paperwork Reduction Act (PRA) of 1995, this notice announces that the Veterans Benefits 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 it includes the actual data collection instrument. DATES: Comments must be submitted on or before May 1, 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. 2900–0802’’ in any correspondence. 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. 2900–0802’’ in any correspondence. SUPPLEMENTARY INFORMATION: sradovich on DSK3GMQ082PROD with NOTICES SUMMARY: Authority: 44 U.S.C. 3501–21. Title: Shoulder and Arm Conditions Disability Benefits Questionnaire (VA Form 21–0960M–12). OMB Control Number: 2900–0802. Type of Review: Extension of a currently approved collection. Abstract: VA Forms 21–0960M–12 is used to gather necessary information VerDate Sep<11>2014 16:31 Mar 30, 2017 Jkt 241001 from a claimant’s treating physician regarding the results of medical examinations. 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 at Volume 82 FR 8568, Thursday, January 26, 2017. Affected Public: Individuals or Households. Estimated Annual Burden: 25,000. Estimated Average Burden per Respondent: 30 minutes. Frequency of Response: One time. Estimated Number of Respondents: 50,000. By direction of the Secretary: Cynthia Harvey-Pryor, Department Clearance Officer, Office of Privacy and Records Management, Department of Veterans Affairs. [FR Doc. 2017–06349 Filed 3–30–17; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0028] Agency Information Collection Activity: Request for and Consent to Release of Information From Claimant’s Records Office of Information and Technology, Department of Veterans Affairs. ACTION: Notice. AGENCY: The Office of Information and Technology (IT), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain information used 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 revision of a currently approved collection, and allow 60 days for public comment in response to this notice. This notice solicits comments for information needed from service organizations requesting to be placed on VA’s mailing lists for specific publications; to request additional information from the correspondent to identify a veteran; to request for and consent to release of information from claimant’s records to a third party; and to determine an applicant’s eligibility to SUMMARY: PO 00000 Frm 00070 Fmt 4703 Sfmt 4703 receive a list of names and addresses of Veterans and their dependents. DATES: Written comments and recommendations on the proposed collection of information should be received on or before May 30, 2017. ADDRESSES: Submit written comments on the collection of information through Federal Docket Management System (FDMS) at www.Regulations.gov or to Martin L. Hill, Office of Information and Technology (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420 or email: martin.hill@va.gov. Please refer to ‘‘2900–0028’’ in any correspondence. During the comment period, comments may be viewed online through the FDMS. FOR FURTHER INFORMATION CONTACT: Martin L. Hill at (202) 632–7452. 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, IT invites comments on: (1) Whether the proposed collection of information is necessary for the proper performance of IT’s functions, including whether the information will have practical utility; (2) the accuracy of IT’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. Application of Service Representative for Placement on Mailing List, VA Form 3215. b. Request for and Consent to Release of Information from Claimant’s Records, VA Form 3288. c. Request to Correspondent for Identifying Information, VA Form Letter 70–2. d. 38 CFR 1.519(A) Lists of Names and Addresses. OMB Control Number: 2900–0028. Type of Review: Extension without change of a currently approved collection. Abstract: a. VA operates an outreach services program to ensure Veterans and beneficiaries have information about E:\FR\FM\31MRN1.SGM 31MRN1 Federal Register / Vol. 82, No. 61 / Friday, March 31, 2017 / Notices sradovich on DSK3GMQ082PROD with NOTICES benefits and services to which they may be entitled. To support the program, VA distributes copies of publications to Veterans Service Organizations’ representatives to be used in rendering services and representation of veterans, their spouses and dependents. Service organizations complete VA Form 3215 to request placement on a mailing list for specific VA publications. b. Veterans or beneficiaries complete VA Form 3288 to provide VA with a written consent to release his or her records or information to third parties such as insurance companies, physicians and other individuals. c. VA Form Letter 70–2 is used to obtain additional information from a correspondent when the incoming correspondence does not provide sufficient information to identify a Veteran. VA personnel use the information to identify the Veteran, determine the location of a specific file, and to accomplish the action requested by the correspondent such as processing a benefit claim or file material in the individual’s claims folder. d. Title 38 U.S.C. 5701(f)(1) authorized the disclosure of names or VerDate Sep<11>2014 16:31 Mar 30, 2017 Jkt 241001 addresses, or both of present or former members of the Armed Forces and/or their beneficiaries to nonprofit organizations (including members of Congress) to notify Veterans of Title 38 benefits and to provide assistance to Veterans in obtaining these benefits. This release includes VA’s Outreach Program for the purpose of advising Veterans of non-VA Federal State and local benefits and programs. Affected Public: Individuals or households, Not for profit institutions, and State, local or tribal government. Estimated Annual Burden: a. Application of Service Representative for Placement on Mailing List, VA Form 3215—25 hours. b. Request for and Consent to Release of Information From Claimant’s Records, VA Form 3288—18,875 hours. c. Request to Correspondent for Identifying Information, VA Form Letter 70–2—3,750 hours. d. 38 CFR 1.519(A) Lists of Names and Addresses—50 hours. Estimated Average Burden Per Respondent: a. Application of Service Representative for Placement on Mailing List, VA Form 3215—10 minutes. PO 00000 Frm 00071 Fmt 4703 Sfmt 9990 16089 b. Request for and Consent to Release of Information From Claimant’s Records, VA Form 3288—7.5 minutes. c. Request to Correspondent for Identifying Information, VA Form Letter 70–2—5 minutes. d. 38 CFR 1.519(A) Lists of Names and Addresses—60 minutes. Frequency of Response: On occasion. Estimated Number of Respondents: a. Application of Service Representative for Placement on Mailing List, VA Form 3215—150. b. Request for and Consent to Release of Information From Claimant’s Records, VA Form 3288—151,000. c. Request to Correspondent for Identifying Information, VA Form Letter 70–2—45,000. d. 38 CFR 1.519(A) Lists of Names and Addresses—50. By direction of the Secretary. Cynthia Harvey-Pryor, Department Clearance Officer, Office of Privacy and Records Management, Department of Veterans Affairs. [FR Doc. 2017–06350 Filed 3–30–17; 8:45 am] BILLING CODE 8320–01–P E:\FR\FM\31MRN1.SGM 31MRN1

Agencies

[Federal Register Volume 82, Number 61 (Friday, March 31, 2017)]
[Notices]
[Pages 16088-16089]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-06350]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0028]


Agency Information Collection Activity: Request for and Consent 
to Release of Information From Claimant's Records

AGENCY: Office of Information and Technology, Department of Veterans 
Affairs.

ACTION: Notice.

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SUMMARY: The Office of Information and Technology (IT), Department of 
Veterans Affairs (VA), is announcing an opportunity for public comment 
on the proposed collection of certain information used 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 revision of 
a currently approved collection, and allow 60 days for public comment 
in response to this notice. This notice solicits comments for 
information needed from service organizations requesting to be placed 
on VA's mailing lists for specific publications; to request additional 
information from the correspondent to identify a veteran; to request 
for and consent to release of information from claimant's records to a 
third party; and to determine an applicant's eligibility to receive a 
list of names and addresses of Veterans and their dependents.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before May 30, 2017.

ADDRESSES: Submit written comments on the collection of information 
through Federal Docket Management System (FDMS) at www.Regulations.gov 
or to Martin L. Hill, Office of Information and Technology (005R1B), 
Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 
20420 or email: martin.hill@va.gov. Please refer to ``2900-0028'' in 
any correspondence. During the comment period, comments may be viewed 
online through the FDMS.

FOR FURTHER INFORMATION CONTACT: Martin L. Hill at (202) 632-7452.

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, IT invites 
comments on: (1) Whether the proposed collection of information is 
necessary for the proper performance of IT's functions, including 
whether the information will have practical utility; (2) the accuracy 
of IT'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. Application of Service Representative for Placement on Mailing 
List, VA Form 3215.
    b. Request for and Consent to Release of Information from 
Claimant's Records, VA Form 3288.
    c. Request to Correspondent for Identifying Information, VA Form 
Letter 70-2.
    d. 38 CFR 1.519(A) Lists of Names and Addresses.
    OMB Control Number: 2900-0028.
    Type of Review: Extension without change of a currently approved 
collection.
    Abstract:
    a. VA operates an outreach services program to ensure Veterans and 
beneficiaries have information about

[[Page 16089]]

benefits and services to which they may be entitled. To support the 
program, VA distributes copies of publications to Veterans Service 
Organizations' representatives to be used in rendering services and 
representation of veterans, their spouses and dependents. Service 
organizations complete VA Form 3215 to request placement on a mailing 
list for specific VA publications.
    b. Veterans or beneficiaries complete VA Form 3288 to provide VA 
with a written consent to release his or her records or information to 
third parties such as insurance companies, physicians and other 
individuals.
    c. VA Form Letter 70-2 is used to obtain additional information 
from a correspondent when the incoming correspondence does not provide 
sufficient information to identify a Veteran. VA personnel use the 
information to identify the Veteran, determine the location of a 
specific file, and to accomplish the action requested by the 
correspondent such as processing a benefit claim or file material in 
the individual's claims folder.
    d. Title 38 U.S.C. 5701(f)(1) authorized the disclosure of names or 
addresses, or both of present or former members of the Armed Forces 
and/or their beneficiaries to nonprofit organizations (including 
members of Congress) to notify Veterans of Title 38 benefits and to 
provide assistance to Veterans in obtaining these benefits. This 
release includes VA's Outreach Program for the purpose of advising 
Veterans of non-VA Federal State and local benefits and programs.
    Affected Public: Individuals or households, Not for profit 
institutions, and State, local or tribal government.
    Estimated Annual Burden:
    a. Application of Service Representative for Placement on Mailing 
List, VA Form 3215--25 hours.
    b. Request for and Consent to Release of Information From 
Claimant's Records, VA Form 3288--18,875 hours.
    c. Request to Correspondent for Identifying Information, VA Form 
Letter 70-2--3,750 hours.
    d. 38 CFR 1.519(A) Lists of Names and Addresses--50 hours.
    Estimated Average Burden Per Respondent:
    a. Application of Service Representative for Placement on Mailing 
List, VA Form 3215--10 minutes.
    b. Request for and Consent to Release of Information From 
Claimant's Records, VA Form 3288--7.5 minutes.
    c. Request to Correspondent for Identifying Information, VA Form 
Letter 70-2--5 minutes.
    d. 38 CFR 1.519(A) Lists of Names and Addresses--60 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents:
    a. Application of Service Representative for Placement on Mailing 
List, VA Form 3215--150.
    b. Request for and Consent to Release of Information From 
Claimant's Records, VA Form 3288--151,000.
    c. Request to Correspondent for Identifying Information, VA Form 
Letter 70-2--45,000.
    d. 38 CFR 1.519(A) Lists of Names and Addresses--50.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Office of Privacy and Records Management, 
Department of Veterans Affairs.
[FR Doc. 2017-06350 Filed 3-30-17; 8:45 am]
BILLING CODE 8320-01-P