Agency Information Collection Activity Under OMB Review: Presidential Memorial Certificate Form, 16475-16476 [2017-06574]

Download as PDF 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 16476 Federal Register / Vol. 82, No. 63 / Tuesday, April 4, 2017 / Notices omb.eop.gov. Please refer to ‘‘OMB Control No. 2900–0567’’ 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. 2900–0567’’ in any correspondence. SUPPLEMENTARY INFORMATION: asabaliauskas on DSK3SPTVN1PROD with NOTICES Title: Presidential Memorial Certificate Form VA Form 40–0247. OMB Control Number: 2900–0567. Type of Review: Revision of a currently approved collection. Abstract: The National Cemetery Administration (NCA) made updates to its current VA Form 40–0247. The VerDate Sep<11>2014 16:21 Apr 03, 2017 Jkt 241001 original VA Form 40–0247 is for requests for initial copies of a Presidential Memorial Certificates (PMC’s). The updates to the form would include the following changes with no additional respondent burden: • Format changes • SSN or Military Service Number from discharge Documents • Mailing address, email address, telephone and fax number updates • Wording changed to allow the public to also use the form for first time requests Upon appropriate approval, the NCA Web site will display the updated version of the VA Form 40–0247 for public use. 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 PO 00000 Frm 00143 Fmt 4703 Sfmt 9990 control number. The Federal Register Notice with a 60-day comment period soliciting comments on this collection of information was published at 82 FRN 06728 on January 19, 2017. Affected Public: 125,000. Estimated Annual Burden: 6,250 hours. Estimated Average Burden Per Respondent: 3 minutes each. Frequency of Response: One-time. Estimated Number of Respondents: 125,000. 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. 2017–06574 Filed 4–3–17; 8:45 am] BILLING CODE 8320–01–P E:\FR\FM\04APN1.SGM 04APN1

Agencies

[Federal Register Volume 82, Number 63 (Tuesday, April 4, 2017)]
[Notices]
[Pages 16475-16476]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-06574]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0567]


Agency Information Collection Activity Under OMB Review: 
Presidential Memorial Certificate Form

AGENCY: National Cemetery Administration, Department of Veterans 
Affairs.

ACTION: Notice.

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

SUMMARY: 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@

[[Page 16476]]

omb.eop.gov. Please refer to ``OMB Control No. 2900-0567'' 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-
0567'' in any correspondence.

SUPPLEMENTARY INFORMATION:
    Title: Presidential Memorial Certificate Form VA Form 40-0247.
    OMB Control Number: 2900-0567.
    Type of Review: Revision of a currently approved collection.
    Abstract: The National Cemetery Administration (NCA) made updates 
to its current VA Form 40-0247. The original VA Form 40-0247 is for 
requests for initial copies of a Presidential Memorial Certificates 
(PMC's). The updates to the form would include the following changes 
with no additional respondent burden:

 Format changes
 SSN or Military Service Number from discharge Documents
 Mailing address, email address, telephone and fax number 
updates
 Wording changed to allow the public to also use the form for 
first time requests

Upon appropriate approval, the NCA Web site will display the updated 
version of the VA Form 40-0247 for public use.

    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 06728 on January 19, 2017.
    Affected Public: 125,000.
    Estimated Annual Burden: 6,250 hours.
    Estimated Average Burden Per Respondent: 3 minutes each.
    Frequency of Response: One-time.
    Estimated Number of Respondents: 125,000.

    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. 2017-06574 Filed 4-3-17; 8:45 am]
BILLING CODE 8320-01-P