30-Day FRN - 2900-NEW (2017)

30-Day FRN - 2900-NEW (VA Form 29-0975) 2017.pdf

Authorization to Disclose Information to a Third Party (Insurance) (VA Form 29-0975)

30-Day FRN - 2900-NEW (2017)

OMB: 2900-0856

Document [pdf]
Download: pdf | pdf
20688

Federal Register / Vol. 82, No. 84 / Wednesday, May 3, 2017 / Notices

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 [email protected]. Please refer to ‘‘OMB
Control No. 2900–0500’’ in any
correspondence.
Authority: 44 U.S.C. 3501–21.
Title: Mandatory Status of Dependents
(VA Form 21–0538).
OMB Control Number: 2900–0500.
Type of Review: Revision of a
currently approved collection.
Abstract: VA Form 21–0538 is used to
request certification of the status of
dependents for whom additional
compensation is being paid to veterans.
Without this information, continued
entitlement to the benefits for
dependents could not be determined.
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 13 on January 23, 2017, pages
7917 and 7918.
Affected Public: Individuals or
Households.
Estimated Annual Burden: 14,083.
Estimated Average Burden Per
Respondent: 10 minutes.
Frequency of Response: One time.
Estimated Number of Respondents:
84,500.
By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Enterprise
Records Service, Office of Quality and
Compliance, Department of Veterans Affairs.

nlaroche on DSK30NT082PROD with NOTICES

BILLING CODE 8320–01–P

VerDate Sep<11>2014

14:29 May 02, 2017

Jkt 241001

[OMB Control No. 2900–NEW]

Agency Information Collection Activity
Under OMB Review: Authorization To
Disclose Personal Information to a
Third Party (Insurance)
Veterans Benefits
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:

SUPPLEMENTARY INFORMATION:

[FR Doc. 2017–08930 Filed 5–2–17; 8:45 am]

DEPARTMENT OF VETERANS
AFFAIRS

In compliance with the
Paperwork Reduction Act (PRA) of
1995, this notice announces that the
Veterans Benefits Administration
(VBA), 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 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–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 [email protected]. Please refer to ‘‘OMB
Control No. 2900–NEW.’’
SUMMARY:

PO 00000

Frm 00130

Fmt 4703

Sfmt 9990

SUPPLEMENTARY INFORMATION:

Authority: 44 U.S.C. 3501–3521.
Title: Authorization to Disclose
Personal Information to a Third Party
(Insurance).
OMB Control Number: 2900–NEW.
Type of Review: New collection.
Abstract: VA Form 29–0975 will be
used by the Department of Veterans
Affairs Insurance Center (VAIC) to
enable a third party to act on behalf of
the insured Veteran/beneficiary. Many
of our customers are of advanced age or
suffer from limiting disabilities and
need assistance from a third party to
conduct their affairs. The information
collected provides an optional service
and is not required to receive insurance
benefits.
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 on page 6729, January 19, 2017.
Affected Public: Individuals or
households.
Estimated Annual Burden: 100 hours.
Estimated Average Burden per
Respondent: 5 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
1200.
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. 2017–08931 Filed 5–2–17; 8:45 am]
BILLING CODE 8320–01–P

E:\FR\FM\03MYN1.SGM

03MYN1


File Typeapplication/pdf
File Modified2017-05-03
File Created2017-05-03

© 2024 OMB.report | Privacy Policy