Agency Information Collection Activity: Statement in Support of Claim, 20687 [2017-08933]

Download as PDF Federal Register / Vol. 82, No. 84 / Wednesday, May 3, 2017 / Notices Register on Monday, January 23, 2017 that contained an error. The 60-day Public Comment notice identified the wrong title for the Agency Information Collection Activity. This document serves as Notice for change of the title: ‘‘Status of Dependents Questionnaire’’ with the revised title: ‘‘Mandatory Status of Dependents.’’ 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. 2017–01398, published on Monday, January 23, 2017 at 82 FR 13, the following was in error. Pages 7917 and 7918, displayed ‘‘Agency Information Collection Activity: Status of Dependents Questionnaire (VA Form 21–0538),’’ and also under SUPPLEMENTARY INFORMATION: Title: Status of Dependents Questionnaire (VA Form 21–0538).’’ Publication of the 30day Federal Register Notice comment period will display the revised titles: Agency Information Collection Activity: Mandatory Status of Dependents SUPPLEMENTARY INFORMATION: Title: Mandatory Status of Dependents.’’ Dated: April 26, 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. 2017–08929 Filed 5–2–17; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0075] Agency Information Collection Activity: Statement in Support of Claim 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 revision of a currently approved nlaroche on DSK30NT082PROD with NOTICES SUMMARY: VerDate Sep<11>2014 14:29 May 02, 2017 Jkt 241001 collection, and allow 60 days for public comment in response to the notice. VA Form 21–4138 is used by claimants to provide self-certified statements in support of various types of claims processed by the agency. VA compensation and pension programs require that statements submitted by or on behalf of a claimant contain certification by the respondent that the information provided is true and correct. This form is designed to facilitate claims processing by providing a uniform format for the certification statement. DATES: Written comments and recommendations on the proposed collection of information should be received on or before July 3, 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. 2900–0075’’ 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, 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. Authority: Public Law 104–13; 44 U.S.C. 3501–21. Title: Statement in Support of Claim, VA Form 21–4138. OMB Control Number: 2900–0075. Type of Review: Revision of an approved collection. PO 00000 Frm 00129 Fmt 4703 Sfmt 4703 20687 Abstract: VA Form 21–4138 is used by claimants to provide self-certified statements in support of various types of claims processed by the agency. VA compensation and pension programs require that statements submitted by or on behalf of a claimant contain certification by the respondent that the information provided is true and correct. This form is designed to facilitate claims processing by providing a uniform format for the certification statement. Affected Public: Individuals or households. Estimated Annual Burden: 188,000. Estimated Average Burden per Respondent: 15 minutes. Frequency of Response: One time. Estimated Number of Respondents: 752,000. 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. 2017–08933 Filed 5–2–17; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0500] Agency Information Collection Activity Under OMB Review: Mandatory Status of Dependents 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 June 2, 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. 2900–0500’’ in any correspondence. SUMMARY: E:\FR\FM\03MYN1.SGM 03MYN1

Agencies

[Federal Register Volume 82, Number 84 (Wednesday, May 3, 2017)]
[Notices]
[Page 20687]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-08933]


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

DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0075]


Agency Information Collection Activity: Statement in Support of 
Claim

AGENCY: Veterans Benefits Administration, Department of Veterans 
Affairs.

ACTION: Notice.

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

SUMMARY: 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 revision of 
a currently approved collection, and allow 60 days for public comment 
in response to the notice.
    VA Form 21-4138 is used by claimants to provide self-certified 
statements in support of various types of claims processed by the 
agency. VA compensation and pension programs require that statements 
submitted by or on behalf of a claimant contain certification by the 
respondent that the information provided is true and correct. This form 
is designed to facilitate claims processing by providing a uniform 
format for the certification statement.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before July 3, 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. 2900-0075'' 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, 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.
    Authority: Public Law 104-13; 44 U.S.C. 3501-21.
    Title: Statement in Support of Claim, VA Form 21-4138.
    OMB Control Number: 2900-0075.
    Type of Review: Revision of an approved collection.
    Abstract: VA Form 21-4138 is used by claimants to provide self-
certified statements in support of various types of claims processed by 
the agency. VA compensation and pension programs require that 
statements submitted by or on behalf of a claimant contain 
certification by the respondent that the information provided is true 
and correct. This form is designed to facilitate claims processing by 
providing a uniform format for the certification statement.
    Affected Public: Individuals or households.
    Estimated Annual Burden: 188,000.
    Estimated Average Burden per Respondent: 15 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents: 752,000.

    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. 2017-08933 Filed 5-2-17; 8:45 am]
BILLING CODE 8320-01-P
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.