60-day FRN(2900-0776)

60-day FRN(2900-0776).pdf

Disability Benefits Questionnaires (Group 2)

60-day FRN(2900-0776)

OMB: 2900-0776

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Federal Register / Vol. 79, No. 12 / Friday, January 17, 2014 / Notices
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 on
September 6, 2013, at pages 54957–
54958.
Affected Public: Individuals or
households.
Estimated Annual Burden: 500.
Estimated Average Burden per
Respondent: 6 minutes.
Frequency of Response: Annually.
Estimated Number of Respondents:
5,000.
Dated: January 14, 2014.
By direction of the Secretary.
Crystal Rennie,
VA Clearance Officer, Department of Veterans
Affairs.
[FR Doc. 2014–00896 Filed 1–16–14; 8:45 am]
BILLING CODE 8320–01–P

DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0080]

Proposed Information Collection
(Funeral Arrangements Form for
Disposition of Remains of the
Deceased) Activity: Comment Request
Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:

The Veterans Health
Administration (VHA) 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
extension of a currently approved
collection, and allow 60 days for public
comment in response to the notice. This
notice solicits comments on information
needed to identify areas for
improvement in clinical training
programs.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before March 18, 2014.
ADDRESSES: Submit written comments
on the collection of information through
the Federal Docket Management System
(FDMS) at www.Regulations.gov; or to
Audrey Revere, Office of Regulatory and
Administrative Affairs, Veterans Health
Administration (10B4), Department of
Veterans Affairs, 810 Vermont Avenue

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SUMMARY:

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NW., Washington, DC 20420 or email:
[email protected]. Please refer to
‘‘OMB Control No. 2900–0080’’ in any
correspondence. During the comment
period, comments may be viewed online
through FDMS.
FOR FURTHER INFORMATION CONTACT:
Audrey Revere at (202) 461–5694.
SUPPLEMENTARY INFORMATION: Under the
PRA of 1995 (Pub. L. 104–13; 44 U.S.C.
3501–3521), Federal agencies must
obtain approval from 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.
Title: Funeral Arrangements Form for
Disposition of Remains of the Deceased,
VA Form 10–2065.
OMB Control Number: 2900–0080.
Type of Review: Extension of a
currently approved collection.
Abstracts: VA Form 10–2065 is
completed by VA personnel during an
interview with relatives of the deceased,
and to identify the funeral home to
which the remains are to be released.
The form is also used as a control
document when VA is requested to
arrange for the transportation of the
deceased from the place of death to the
place of burial, and/or when burial is
requested in a National Cemetery.
Affected Public: Business or other forprofit.
Estimated Total Annual Burden:
3,072 hours.
Estimated Average Burden per
Respondent: 10 minutes.
Frequency of Response: Annually.
Estimated Number of Respondents:
22,213.
Dated: January 13, 2014.
By direction of the Secretary.
Crystal Rennie,
VA Clearance Officer, U.S. Department of
Veterans Affairs.
[FR Doc. 2014–00759 Filed 1–16–14; 8:45 am]
BILLING CODE 8320–01–P

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3275

DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0776 (DBQs—
Group 2)]

Proposed Information Collection
(Disability Benefits Questionnaires—
Group 2) Activity: Comment Request
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
extension without change of a currently
approved collection and allow 60 days
for public comment in response to the
notice. This notice solicits comments for
information needed to obtain medical
evidence to adjudicate a claim for
disability benefits.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before March 18, 2014.
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
[email protected]. Please refer to
‘‘OMB Control No. 2900–0776 (DBQs—
Group 2)’’ in any correspondence.
During the comment period, comments
may be viewed online through FDMS.
FOR FURTHER INFORMATION CONTACT:
Nancy J. Kessinger at (202) 632–8924 or
FAX (202) 632–8925.
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, 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;
SUMMARY:

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3276

Federal Register / Vol. 79, No. 12 / Friday, January 17, 2014 / Notices

(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.
Titles:
a. Arteries and Veins Conditions
(Vascular Diseases including Varicose
Veins) Disability Benefits
Questionnaire, VA Form 21–0960A–2.
b. Hypertension Disability Benefits
Questionnaire, VA Form 21–0960A–3.
c. Non-ischemic Heart Disease
(including Arrhythmias and Surgery,
Disability Benefits Questionnaire, VA
Form 21–0960A–4.
d. Diabetic Peripheral Neuropathy
(Diabetic Sensory-Motor Peripheral
Neuropathy), Disability Benefits
Questionnaire, VA Form 21–0960C–4.
e. Diabetes Mellitus Disability
Benefits Questionnaire, VA Form 21–
0960E–1.
f. Scar/Disfigurement Disability
Benefits Questionnaire, VA Form 21–
0960F–1.
g. Skin Diseases Disability Benefits
Questionnaire, VA Form 21–0960F–2.
h. Amputations Disability Benefits
Questionnaire, VA Form 21–0960M–1.
i. Ankle Conditions Disability
Benefits Questionnaire, VA Form 21–
0960M–2.
j. Elbow and Forearm Conditions
Disability Benefits Questionnaire, VA
Form 21–0960M–4.
k. Flatfoot (PES PLANUS) Disability
Benefits Questionnaire, VA Form 21–
0960M–5.
l. Foot Miscellaneous (other than
flatfoot/PES PLANUS), Disability
Benefits Questionnaire, VA Form 21–
0960M–6.
m. Hand and Finger Conditions
Disability Benefits Questionnaire, VA
Form 21–0960M–7.
n. Hip and Thigh Conditions
Disability Benefits Questionnaire, VA
Form 21–0960M–8.
o. Knee and Lower Leg Conditions
Disability Benefits Questionnaire, VA
Form 21–0960M–9.
p. Muscle Injuries Disability Benefits
Questionnaire, VA Form 21–0960M–10.
q. Shoulder and Arm Conditions
Disability Benefits Questionnaire, VA
Form 21–0960M–12.
r. Temporomandibular Joint (TMJ)
Conditions Disability Benefits
Questionnaire, VA Form 21–0960M–15.
s. Wrist Conditions Disability Benefits
Questionnaire, VA Form 21–0960M–16.
t. Eye Conditions Disability Benefits
Questionnaire, VA Form 21–0960N–2.

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OMB Control Number: 2900–0776
(DBQs—Group 2).
Type of Review: Extension without
change of a currently approved
collection.
Abstract: Data collected on VA Form
21–0960 series will be used obtain
information from claimants treating
physician that is necessary to adjudicate
a claim for disability benefits.
Affected Public: Individuals or
households.
Estimated Annual Burden:
a. VA Form 21–0960A–2—10,000.
b. VA Form 21–0960A–3—12,500.
c. VA Form 21–0960A–4—10,000.
d. VA Form 21–0960C–4—37,500.
e. VA Form 21–0960E–1—18,750.
f. VA Form 21–0960F–1—6,250.
g. VA Form 21–0960F–2—6,250.
h. VA Form 21–0960M–1—12,500.
i. VA Form 21–0960M–2—15,000.
j. VA Form 21–0960M–4—10,000.
k. VA Form 21–0960M–5—12,500.
l. VA Form 21–0960M–6—7,500.
m. VA Form 21–0960M–7—15,000.
n. VA Form 21–0960M–8—25,000.
o. VA Form 21–0960M–9—25,000.
p. VA Form 21–0960M–10—15,000.
q. VA Form 21–0960M–12—25,000.
r. VA Form 21–0960M–15—3,750.
s. VA Form 21–0960M–16—20,000.
t. VA Form 21–0960N–2—30,000.
Estimated Average Burden per
Respondent:
a. VA Form 21–0960A–2—30
minutes.
b. VA Form 21–0960A–3—15
minutes.
c. VA Form 21–0960A–4—30
minutes.
d. VA Form 21–0960C–4—30
minutes.
e. VA Form 21–0960E–1—15 minutes.
f. VA Form 21–0960F–1—15 minutes.
g. VA Form 21–0960F–2—15 minutes.
h. VA Form 21–0960M–1—30
minutes.
i. VA Form 21–0960M–2—30
minutes.
j. VA Form 21–0960M–4—30 minutes.
k. VA Form 21–0960M–5—15
minutes.
l. VA Form 21–0960M–6—15
minutes.
m. VA Form 21–0960M–7—30
minutes.
n. VA Form 21–0960M–8—30
minutes.
o. VA Form 21–0960M–9—30
minutes.
p. VA Form 21–0960M–10—30
minutes.
q. VA Form 21–0960M–12—30
minutes.
r. VA Form 21–0960M–15—15
minutes.
s. VA Form 21–0960M–16—30
minutes.

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t. VA Form 21–0960N–2—45 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
a. VA Form 21–0960A–2—20,000.
b. VA Form 21–0960A–3—50,000.
c. VA Form 21–0960A–4—20,000.
d. VA Form 21–0960C–4—75,000.
e. VA Form 21–0960E–1—75,000.
f. VA Form 21–0960F–1—25,000.
g. VA Form 21–0960F–2—25,000.
h. VA Form 21–0960M–1—25,000.
i. VA Form 21–0960M–2—30,000.
j. VA Form 21–0960M–4—20,000.
k. VA Form 21–0960M–5—50,000.
l. VA Form 21–0960M–6—30,000.
m. VA Form 21–0960M–7—30,000.
n. VA Form 21–0960M–8—50,000.
o. VA Form 21–0960M–9—50,000.
p. VA Form 21–0960M–10—30,000.
q. VA Form 21–0960M–12—50,000.
r. VA Form 21–0960M–15—15,000.
s. VA Form 21–0960M–16—40,000.
t. VA Form 21–0960N–2—40,000.
Dated: January 13, 2014.
By direction of the Secretary.
Crystal Rennie,
VA Clearance Officer, Department of Veterans
Affairs.
[FR Doc. 2014–00782 Filed 1–16–14; 8:45 am]
BILLING CODE 8320–01–P

DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900—NEW]

Agency Information Collection (Bowel
and Bladder Care Billing Form)
Activities Under OMB Review
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:

Written comments and
recommendations on the proposed
collection of information should be
received on or before February 18, 2014.
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:
DATES:

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