Agency Information Collection Activity Under OMB Review: Income Verification, 16474-16475 [2017-06573]

Download as PDF 16474 Federal Register / Vol. 82, No. 63 / Tuesday, April 4, 2017 / Notices retained on the bank or Federal savings association’s balance sheet as of that day. The OCC will use the information to verify the accuracy of each national bank’s and Federal savings association’s assessment computation and to adjust the assessment rate for independent credit card institutions over time. Estimated Number of Respondents: 12. Estimated Total Annual Burden: 24 hours. Comments submitted in response to this notice will be summarized and included in the request for OMB approval. All comments will become a matter of public record. Comments are invited on: (a) Whether the collection of information is necessary for the proper performance of the functions of the OCC, including whether the information has practical utility; (b) The accuracy of the OCC’s estimate of the information collection burden; (c) Ways to enhance the quality, utility, and clarity of the information to be collected; (d) Ways to minimize the burden of the collection on respondents, including through the use of automated collection techniques or other forms of information technology; and (e) Estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to provide information. Dated: March 29, 2017. Karen Solomon, Deputy Chief Counsel, Office of the Comptroller of the Currency. [FR Doc. 2017–06643 Filed 4–3–17; 8:45 am] BILLING CODE 4810–33–P DEPARTMENT OF THE TREASURY Office of Foreign Assets Control Sanctions Actions Pursuant to Executive Order 13224 Office of Foreign Assets Control, Treasury. ACTION: Notice. AGENCY: The Department of the Treasury’s Office of Foreign Assets Control (OFAC) is publishing the names of 2 individuals whose property and interests in property are blocked pursuant to Executive Order 13224 of September 23, 2001, ‘‘Blocking Property and Prohibiting Transactions With Persons Who Commit, Threaten To Commit, or Support Terrorism.’’ DATES: OFAC’s actions described in this notice were effective on March 30, 2017. asabaliauskas on DSK3SPTVN1PROD with NOTICES SUMMARY: VerDate Sep<11>2014 16:21 Apr 03, 2017 Jkt 241001 FOR FURTHER INFORMATION CONTACT: Associate Director for Global Targeting, tel.: 202/622–2420, Assistant Director for Sanctions Compliance & Evaluation, tel.: 202/622–2490, Assistant Director for Licensing, tel.: 202/622–2480, Office of Foreign Assets Control, or Chief Counsel (Foreign Assets Control), tel.: 202/622–2410, Office of the General Counsel, Department of the Treasury (not toll free numbers). SUPPLEMENTARY INFORMATION: The SDN List and additional information concerning OFAC sanctions programs are available from OFAC’s Web site (www.treas.gov/ofac). Notice of OFAC Actions On March 30, 2017, OFAC blocked the property and interests in property of the following 2 individuals pursuant to E.O. 13224, ‘‘Blocking Property and Prohibiting Transactions With Persons Who Commit, Threaten To Commit, or Support Terrorism’’: Individuals 1. TAMTOMO, Muhammad Bahrun Naim Anggih (a.k.a. NAIM, Bahrun; a.k.a. TAMTOMO, Anggih; a.k.a. ‘‘AISYAH, Abu’’; a.k.a. ‘‘RAYAN, Abu’’; a.k.a. ‘‘RAYYAN, Abu’’), Aleppo, Syria; Raqqa, Syria; DOB 06 Sep 1983; POB Surakarta, Indonesia; alt. POB Pekalongan, Indonesia; nationality Indonesia; Gender Male (individual) [SDGT] (Linked To: ISLAMIC STATE OF IRAQ AND THE LEVANT). 2. JEDI, Muhammad Wanndy Bin Mohamed (a.k.a. JEDI, Muhamad Wanndy bin Muhamad; a.k.a. JEDI, Muhamad Wanndy Mohamad; a.k.a. JEDI, Muhamad Wanndy Muhamad; a.k.a. WANNDY, Muhamad; a.k.a. ‘‘AL– FATEH, Abu Hamzah’’; a.k.a. ‘‘AL– MALIZI, Abu Sayyaf’’), Syria; DOB 16 Nov 1990; alt. DOB 1989 to 1991; POB Durian Tunggal, Malacca, Malaysia; nationality Malaysia; Gender Male; Passport A33373751 (Malaysia); National ID No. 90116–04–5293 (individual) [SDGT] (Linked To: ISLAMIC STATE OF IRAQ AND THE LEVANT). Dated: March 30, 2017. Andrea Gacki, Acting Director, Office of Foreign Assets Control. [FR Doc. 2017–06598 Filed 4–3–17; 8:45 am] PO 00000 Frm 00141 Fmt 4703 Sfmt 4703 [OMB Control No. 2900–NEW] Agency Information Collection Activity Under OMB Review: Income Verification Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: In compliance with the Paperwork Reduction Act (PRA) of 1995, 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; it includes the actual data collection instrument. DATES: Comments must be submitted on or before May 4, 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–NEW’’ in any correspondence. SUMMARY: Electronic Availability BILLING CODE 4810–AL–P DEPARTMENT OF VETERANS AFFAIRS 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–NEW.’’ SUPPLEMENTARY INFORMATION: 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 Veteran to verify the listed income on the form as reported to IVD by IRS/SSA, to select the appropriate option on the form E:\FR\FM\04APN1.SGM 04APN1 asabaliauskas on DSK3SPTVN1PROD with NOTICES Federal Register / Vol. 82, No. 63 / Tuesday, April 4, 2017 / Notices 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. 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 VerDate Sep<11>2014 16:21 Apr 03, 2017 Jkt 241001 of information was published at 82 FRN 8566–8567 on January 26, 2017. 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 Authority: 44 U.S.C. 3501–3521 16475 FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, at 202–461–5870. CORRECTION In FR Doc. FR Doc. 2017–04559, published on Wednesday, March 8, 2017 at 82FR44, make the following correction. On page 13056, in the third column, in second paragraph section, titled DATES, replace ‘‘DATES: Written comments and recommendations on the proposed collection of information should be received on or before April 7, 2017,’’ to read as follows: DATES: Written comments and recommendations on the proposed collection of information should be received on or before May 7, 2017. Dated: March 29, 2017. By direction of the Secretary: Cynthia Harvey-Pryor, Department Clearance Officer, Enterprise Records Service, Office of Quality and Compliance, Department of Veterans Affairs. [FR Doc. 2017–06572 Filed 4–3–17; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS By direction of the Secretary. Cynthia Harvey-Pryor, Department Clearance Officer, Enterprise Records Service, Office of Quality and Compliance, Department of Veterans Affairs. [OMB Control No. 2900–0567] [FR Doc. 2017–06573 Filed 4–3–17; 8:45 am] AGENCY: BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0657] Conflicting Interests Certification for Proprietary Schools Comment Request Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice; correction. AGENCY: The Department of Veterans Affairs (VA) published a collection of information notice in a Federal Register on Wednesday, March 8, 2017 that contained an error. The intent was to publish a 60-day Public Comment notice. However, the notice incorrectly stated an insert date 30 days after date of publication in the Federal Register in the DATES section. This document corrects the error by updating the public comment date. SUMMARY: PO 00000 Frm 00142 Fmt 4703 Sfmt 4703 Agency Information Collection Activity Under OMB Review: Presidential Memorial Certificate Form National Cemetery Administration, Department of Veterans Affairs. ACTION: Notice. In compliance with the Paperwork Reduction Act (PRA) of 1995, this notice announces that the National Cemetery Administration (NCA), 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 May 4, 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@ SUMMARY: E:\FR\FM\04APN1.SGM 04APN1

Agencies

[Federal Register Volume 82, Number 63 (Tuesday, April 4, 2017)]
[Notices]
[Pages 16474-16475]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-06573]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-NEW]


Agency Information Collection Activity Under OMB Review: Income 
Verification

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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

SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995, 
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; it 
includes the actual data collection instrument.

DATES: Comments must be submitted on or before May 4, 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-
NEW'' 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.harvey-pryor@va.gov. Please refer to ``OMB Control No. 2900-
NEW.''

SUPPLEMENTARY INFORMATION: 
    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 Veteran to verify the listed income 
on the form as reported to IVD by IRS/SSA, to select the appropriate 
option on the form

[[Page 16475]]

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.
    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 82 FRN 8566-8567 on January 26, 2017.
    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

    Authority:  44 U.S.C. 3501-3521


    By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Enterprise Records Service, Office of 
Quality and Compliance, Department of Veterans Affairs.
[FR Doc. 2017-06573 Filed 4-3-17; 8:45 am]
 BILLING CODE 8320-01-P