99-33253. Agency Information Collection Activities Under OMB Review

[Federal Register Volume 64, Number 246 (Thursday, December 23, 1999)]
[Notices]
[Pages 72146-72147]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-33253]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0205]


Agency Information Collection Activities Under OMB Review

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 
(44 U.S.C., 3501 et seq.), this notice announces that the Veterans 
Health Administration (VHA), Department of Veterans Affairs, has 
submitted 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 January 21, 2000.

FOR FURTHER INFORMATION OR A COPY OF THE SUBMISSION CONTACT: Denise 
McLamb, Information Management Service (045A4), Department of Veterans 
Affairs, 810 Vermont Avenue, NW, Washington, DC 20420, [phone] 
or FAX [phone]. Please refer to ``OMB Control No. 2900-0205.''

SUPPLEMENTARY INFORMATION:
    Titles and Form Number:
    a. VA Form 10-2850, Application for Physicians, Dentists, 
Podiatrists and Optometrists.
    b. VA Form 10-2850a, Application for Nurses and Nurse Anesthetists.
    c. VA Form 10-2850b, Application for Residents.
    d. VA Form 10-2850c, Application for Associated Health Occupations.
    e. VA Form FL 10-341a, Appraisal of Applicant.
    OMB Control Number: 2900-0205
    Type of Review: Reinstatement, without change, of a previously 
approved collection for which approval has expired.
    Abstract: VA Forms 10-2850 and 10-2850a through c are applications 
designed specifically to elicit appropriate information about each 
candidate's qualifications for employment with VA. VHA officials use 
the information to evaluate education, professional experience and 
credentials and to determine suitability and grade level of 
applications of physicians, dentists, podiatrists, optometrists, nurses 
and nurse anesthetists, residents, and associated health occupations, 
and appraisal of applicants. The forms require disclosure of details 
about all licenses ever held, Drug Enforcement Administration 
certification, board certification, clinical privileges, revoked 
certification or registrations, liability insurance history, and 
involvement in malpractice proceedings. Form Letter 10-341a is a pre 
employment reference form used to elicit information concerning the 
prior education and/or performance of the Title 38 applicant.
    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 September 20, 1999, at pages 50868-50869.

[[Page 72147]]

    Affected Public: Individuals or Households, Business or other for-
profit, Not-for-profit institutions, Federal Government, State, Local 
or Tribal Government.
    Estimated Annual Burden: 68,610 hours.
    a. VA Form 10-2850, Application for Physicians, Dentists, 
Podiatrists and Optometrists--6,450 hours.
    b. VA Form 10-2850a, Application for Nurses and Nurse 
Anesthetists--25,800 hours.
    c. VA Form 10-2850b, Application for Residents--13,760 hours.
    d. VA Form 10-2850c, Application for Associated Health 
Occupations--8,600 hours.
    e. VA Form FL 10-341a, Appraisal of Applicant--14,000 hours.
    Estimated Average Burden Per Respondent: 27 minutes.
    a. VA Form 10-2850, Application for Physicians, Dentists, 
Podiatrists and Optometrists--30 minutes.
    b. VA Form 10-2850a, Application for Nurses and Nurse 
Anesthetists--30 minutes.
    c. VA Form 10-2850b, Application for Residents--30 minutes.
    d. VA Form 10-2850c, Application for Associated Health 
Occupations--30 minutes.
    e. VA Form FL 10-341a, Appraisal of Applicant--20 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents: 151,220.
    a. VA Form 10-2850, Application for Physicians, Dentists, 
Podiatrists and Optometrists--12,900.
    b. VA Form 10-2850a, Application for Nurses and Nurse 
Anesthetists--51,600.
    c. VA Form 10-2850b, Application for Residents--27,520.
    d. VA Form 10-2850c, Application for Associated Health 
Occupations--17,200.
    e. VA Form FL 10-341a, Appraisal of Applicant--42,000.
    Send comments and recommendations concerning any aspect of the 
information collection to VA's OMB Desk Officer, Allison Eydt, OMB 
Human Resources and Housing Branch, New Executive Office Building, Room 
10235, Washington, DC 20503 [phone]. Please refer to ``OMB 
Control No. 2900-0205'' in any correspondence.

    Dated: December 3, 1999.

    By direction of the Secretary.
Sandra McIntyre,
Program Analyst, Information Management Service.
[FR Doc. 99-33253 Filed 12-22-99; 8:45 am]
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