2012-16104. Agency Information Collection (Income-Net Worth and Employment Statement) Activity Under OMB Review

AGENCY:

Veterans Benefits Administration, Department of Veterans Affairs.

ACTION:

Notice.

SUMMARY:

In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), 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; it includes the actual data collection instrument.

DATES:

Comments must be submitted on or before August 1, 2012.

ADDRESSES:

Submit written comments on the collection of information through www.Regulations.gov or to VA's OMB Desk Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC 20503 [phone]. Please refer to “OMB Control No. 2900-0002” in any correspondence.

FOR FURTHER INFORMATION CONTACT:

Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, [phone], FAX [phone] or email [e-mail]. Please refer to “OMB Control No. 2900-0002.”

SUPPLEMENTARY INFORMATION:

Title: Income-Net Worth and Employment Statement, VA Form 21-527.

OMB Control Number: 2900-0002.

Type of Review: Extension of a currently approved collection.

Abstract: VA Form 21-527 used to obtain current employment, dependency, and family income and net worth information to determine a claimant's entitlement to disability pension.

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 April 6, 2012, at page 20888.

Affected Public: Individuals or Households.

Estimated Annual Burden: 104,440 hours.

Estimated Average Burden per Respondent: 60 minutes.

Frequency of Response: One-time.

Estimated Number of Respondents: 104,440.

Dated: June 27, 2012.

By direction of the Secretary.

Denise McLamb,

Program Analyst, Enterprise Records Service.