60-Day FRN (2900-0075)

2017-08933, 60-Day FRN (2900-0075).pdf

Statement in Support of Claim (VA Form 21-4138)

60-Day FRN (2900-0075)

OMB: 2900-0075

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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

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SUMMARY:

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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
[email protected]. 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.

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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:

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