30-Day FRN (2900-0778, Group 3 DBQs)

2016-11049, 30-Day FRN, Group 3 DBQs.pdf

Disability Benefits Questionnaires (Group 3)

30-Day FRN (2900-0778, Group 3 DBQs)

OMB: 2900-0778

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Federal Register / Vol. 81, No. 91 / Wednesday, May 11, 2016 / Notices

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: Pension Claim Questionnaire for
Farm income, VA Form 21P–4165.
OMB Control Number: 2900–0095.
Type of Review: Revision of a
currently approved collection.
Abstract: The Department of Veterans
Affairs (VA), through its Veterans
Benefits Administration (VBA),
administers an integrated program of
benefits and services, established by
law, for veterans, service personnel and
their survivors.
38 U.S.C. 1521 establishes a pension
benefit for Veterans of a period of war
who are permanently and totally
disabled. 38 U.S.C. 1541 and 38 U.S.C.
1542 establish a survivor’s pension
benefit for the surviving dependents of
Veterans of a period of war.
Entitlement to pension benefits for
Veterans and their surviving dependents
is based on the family’s countable
annual income as required by 38 U.S.C.
1503 and net worth as required by 38
U.S.C. 1522.
The information collected on VA
Form 21P–4165 will be used by VA to
evaluate a claimant’s income and net
worth related to the operation of a farm
for the purpose of establishing
entitlement to pension benefits and to
evaluate a beneficiary’s ongoing
entitlement to pension benefits.
Affected Public: Individuals or
households.
Estimated Annual Burden: 1,038
hours.
Estimated Average Burden per
Respondent: 30 minutes.
Frequency of Response: One time.
Estimated Number of Respondents:
2,075.
By direction of the Secretary.
Kathleen M. Manwell,
Program Analyst, VA Privacy Service, Office
of Privacy and Records Management,
Department of Veterans Affairs.
[FR Doc. 2016–11053 Filed 5–10–16; 8:45 am]
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mstockstill on DSK3G9T082PROD with NOTICES

DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0778]

Agency Information Collection
(Disability Benefits Questionnaires—
Group 3) Activity Under OMB Review
Veterans Benefits
Administration, Department of Veterans
Affairs.

AGENCY:

VerDate Sep<11>2014

17:20 May 10, 2016

Jkt 238001

ACTION:

Notice.

In compliance with the
Paperwork Reduction Act (PRA) of 1995
(44 U.S.C. 3501–21), 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 10, 2016.
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. 2900–0778’’ 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) 632–7492 or email [email protected]. Please refer to ‘‘OMB
Control No. 2900–0778’’ in any
correspondence.
SUPPLEMENTARY INFORMATION:
Title: Disability Benefits
Questionnaires (Group 3).
OMB Control Number: 2900–0778.
Type of Review: Revision of a
currently approved collection.
Abstract: The VA Form 21–0960
series is used to gather necessary
information from a claimant’s treating
physician regarding the results of
medical examinations. VA will gather
medical information related to the
claimant that is necessary to adjudicate
the claim for VA disability 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 on
February 17, 2016, at pages 8129 and
8130.
Affected Public: Individuals or
households.
Estimated Annual Burden: 77,500.
Estimated Average Burden per
Respondent:
i. VAF 21–0960C–5—30 minutes
SUMMARY:

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ii. VAF 21–0960C–8—15 minutes
iii. VAF 21–0960C–9—45 minutes
iv. VAF 21–0960G–1—15 minutes
v. VAF 21–0960G–2—15 minutes
vi. VAF 21–0960G–3—15 minutes
vii. VAF 21–0960G–4—15 minutes
viii. VAF 21–0960G–5—30 minutes
ix. VAF 21–0960G–6—15 minutes
x. VAF 21–0960G–7—15 minutes
xi. VAF 21–0960G–8—15 minutes
xii. VAF 21–0960H–2—15 minutes
xiii. VAF 21–0960K–1—15 minutes
xiv. VAF 21–0960K–2—30 minutes
xv. VAF 21–0960L–2—15 minutes
xvi. VAF 21–0960M–11—15
minutes
xvii. VAF 21–0960N–1—15 minutes
Frequency of Response: One time.
Estimated Number of Respondents:
250,000.
By direction of the Secretary.
Kathleen M. Manwell,
Program Analyst, VA Privacy Service, Office
of Privacy and Records Management,
Department of Veterans Affairs.
[FR Doc. 2016–11049 Filed 5–10–16; 8:45 am]
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DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0036]

Proposed Information Collection
(Statement of Disappearance, VA Form
21P–1775) 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
revision of a currently approved
collection, and allow 60 days for public
comment in response to the notice.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before July 11, 2016.
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
SUMMARY:

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