[Federal Register Volume 60, Number 169 (Thursday, August 31, 1995)]
[Notices]
[Pages 45516-45517]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-21589]
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DEPARTMENT OF VETERANS AFFAIRS
Information Collections Under OMB Review
AGENCY: Veterans Benefits Administration, Department of Veterans
Affairs.
ACTION: Notice.
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SUMMARY: The Veterans Benefits Administration (VBA), Department of
Veterans Affairs, has submitted to the Office of Management and Budget
(OMB) the following proposals for the collection of information under
the provisions of the Paperwork Reduction Act (44 U.S.C. Chapter 35).
OMB Number: 2900-0013
Title and Form Number: Application for United States Flag for Burial
Purposes, VA Form 2008.
Type of Information Collection: Reinstatement, with change, of a
previously approved collection for which approval has expired.
Needs and Uses: The form is used by the public to obtain a burial flag
for a deceased veteran.
Affected Public: Individuals or households--State, Local or Tribal
Government.
Estimated Annual Burden: 125,000 hours.
Estimated Average Burden Per Respondent: 15 minutes.
Frequency of Response: One time.
Estimated Number of Respondents: 500,000 respondents.
OMB Number: 2900-0059
Title and Form Number: Statement of Person Claiming to Have Stood in
Relation of Parent, VA Form 21-524.
Type of Information Collection: Extension of a currently approved
collection.
Needs and Uses: The form is used to secure information about the
relationship of a claimant to the veteran in claims for Pension
Dependency and Indemnity Compensation.
Affected Public: Individuals or households.
Estimated Annual Burden: 4,000 hours.
Estimated Average Burden Per Respondent: 2 hours.
Frequency of Response: On occasion.
Estimated Number of Respondents: 2,000 respondents.
OMB Number: 2900-0077
Title and Form Number: Court-Appointed Fiduciary's Account, VA Form 27-
4706c.
Type of Information Collection: Extension of a currently approved
collection.
Needs and Uses: The form is used to provide the court appointed
fiduciary of a VA beneficiary an acceptable format for providing
accountings to the appointing court. The information is used to
determine whether VA benefits have been properly managed.
Affected Public: Individuals or households--State, Local or Tribal
Government
Estimated Annual Burden: 10,633 hours.
Estimated Average Burden Per Respondent: 30 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents: 5,616 respondents.
OMB Number: 2900-0107
Title and Form Number: Certificate as to Securities, VA Form 27-4709.
Type of Information Collection: Extension of a currently approved
collection.
Needs and Uses: The form is used to verify the existence of savings
bonds or other securities listed as assets on an accounting required by
State or Federal law or regulation.
Affected Public: Individuals or households--Business or other for-
profit--Not-for-profit institutions--State, Local or Tribal Government
Estimated Annual Burden: 2,450 hours (2,100 annual reporting hours and
350 annual recordkeeping hours).
Estimated Average Burden Per Respondent: 13 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents: 4,316 respondents.
OMB Number: 2900-0115
Title and Form Number: Supporting Statement Regarding Marriage, VA Form
21-4171.
[[Page 45517]]
Type of Information Collection: Extension of a currently approved
collection.
Needs and Uses: The form is used to obtain information from individuals
who know, as the result of personal observation, the relationship which
existed between the parties, in those cases in which a common law
marriage is claimed. The information is used to determine if the
marital relationship is established and benefits are payable based on
relationship.
Affected Public: Individuals or households.
Estimated Annual Burden: 800 hours.
Estimated Average Burden Per Respondent: 20 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents: 2,400 respondents.
OMB Number: 2900-0121
Title and Form Number: Obtaining Supplemental Information From Hospital
or Doctor, VA Form Letter 29-551B.
Type of Information Collection: Extension of a currently approved
collection.
Needs and Uses: The form letter is used to request medical information
from the insured's doctor or hospital in connection with disability
insurance benefits.
Affected Public: Individuals or households.
Estimated Annual Burden: 61 hours.
Estimated Average Burden Per Respondent: 15 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents: 244 respondents.
OMB Number: 2900-0255
Title and Form Number: Application for Dependency and Indemnity
Compensation or Death Pension (Including Accrued Benefits and Death
Compensation Where Applicable) From the Department of Veterans Affairs,
VA Form 21-4182.
Type of Information Collection: Extension of a currently approved
collection.
Needs and Uses: The form is used to gather the necessary information
from the survivor to determine initial eligibility for accrued,
dependency and indemnity compensation, death compensation and/or death
pension benefits when an applicant applies for Social Security
benefits.
Affected Public: Individuals or households.
Estimated Annual Burden: 3,500 hours.
Estimated Average Burden Per Respondent: 15 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents: 14,000 respondents.
OMB Number: 2900-0404
Title and Form Number: Veteran's Application for Increased Compensation
Based on Unemployability, VA Form 21-8940.
Type of Information Collection: Extension of a currently approved
collection.
Needs and Uses: The form is used by veterans when making a claim for
increased VA disability compensation based on unemployability.
Affected Public: Individuals or households.
Estimated Annual Burden: 18,000 hours.
Estimated Average Burden Per Respondent: 45 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents: 24,000 respondents.
OMB Number: 2900-0138
Title and Form Number: Request for Details of Expenses, VA Form 21-
8049.
Type of Information Collection: Extension of a currently approved
collection.
Needs and Uses: The form is used to obtain the necessary information to
determine the amount of any deductible expenses paid by the claimant
and/or commercial life insurance received to calculate the appropriate
rate of pension benefits.
Affected Public: Individuals or households.
Estimated Annual Burden: 5,700 hours.
Estimated Average Burden Per Respondent: 15 minutes.
Frequency of Response: One time.
Estimated Number of Respondents: 22,800 respondents.
ADDRESSES: Copies of these submissions may be obtained from Trish
Fineran, Veterans Benefits Administration (20M30), Department of
Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202)
273-6886.
Comments and recommendations concerning the submissions should be
directed to VA's OMB Desk Officer, Allison Eydt, OMB Human Resources
and Housing Branch, New Executive Office Building, Room 10235,
Washington, DC 20503 (202) 395-4650. Do not send requests for benefits
to this address.
DATES: Comments on the information collections should be directed to
the OMB Desk Officer on or before October 2, 1995.
FOR FURTHER INFORMATION CONTACT: Ron Taylor, VA Clearance Officer
(045A4), (202) 565-4412.
Dated: August 21, 1995.
By direction of the Secretary.
Donald L. Neilson,
Director, Information Management Service
[FR Doc. 95-21589 Filed 8-30-95; 8:45 am]
BILLING CODE 8320-01-P
