60-Day FRN

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Federal Register / Vol. 82, No. 16 / Thursday, January 26, 2017 / Notices
Veteran to verify the listed income on
the form as reported to IVD by IRS/SSA,
to select the appropriate option on the
form relating to the household income,
attest to out of pocket medical expenses,
attest to sale of primary home real estate
and attest to separation from spouse for
the income year under the Income
Verification Division’s review. The
Veteran’s signature is required on page
2 of HEC Form 200–1A. If the Veteran
has medical/health limitations that does
not enable the Veteran to physically
sign the form with a wet signature, the
Veteran must mark an ‘‘X’’ to designate
a signature; two witnesses must verify
the ‘‘X’’ as the Veteran’s signature. HEC,
IVD will use the completed HEC Form
200–1A to assist in verifying the
Veteran’s correct gross household
income to ensure the Veteran is placed
in the correct priority group for health
care.
The HEC, IVD uses HEC Form 220–1
(Spouse’s Income Verification
Response) to collect income verification
information, as applicable, from the
Veteran’s spouse by requesting the
spouse to verify the listed income on the
form as reported to IVD by IRS/SSA,
report any additional income not
reported by IRS/SSA and sign and date
the form. If the spouse has medical/
health limitations that does not enable
the spouse to physically sign the form
with a wet signature, the spouse must
mark an ‘‘X’’ to designate a signature;
two witnesses must verify the ‘‘X’’ as
the Veteran’s signature. HEC, IVD will
use the completed HEC Form 220–1 to
assist in verifying the Veteran’s correct
gross household income to ensure the
Veteran is placed in the correct priority
group for health care.
The HEC, IVD uses the HEC Form
340–1 (Declaration of Representative)
for the Veteran and the spouse (if
applicable) to appoint a representative,
authorizing HEC, IVD to release
information to a designated appointee
for a specific income year. Such
information includes confidential
federal tax information, other income,
and medical benefits eligibility related
information. The Veteran and spouse (if
applicable) must sign and date the form.
The HEC, IVD uses the HEC Income
Verification—Additional Information
Checklist to request from the Veteran
any additional information needed to
adjudicate the Income Verification case.
The Veteran providing the requested
information usually results in the best
interest to the Veteran.
Affected Public: Individuals or
households.
Estimated Annual Burden:

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a. Mailed with Veterans’ Initial
Letters—HEC Form 200–1A—89,001
hours
b. Mailed with Spouses’ Initial
Letters—HEC Form 220–1—28,530
hours
c. Mailed to Veterans When
Necessary—HEC Form 340–1—1,701
hours
d. Mailed to Veterans When
Necessary—Checklist—761 hours
Estimated Average Burden per
Respondent:
a. Mailed with Veterans’ Initial
Letters—HEC Form 200–1A—30
minutes
b. Mailed with Spouses’ Initial
Letters—HEC Form 220–1—20 minutes
c. Mailed to Veterans When
Necessary—HEC Form 340–1—15
minutes
d. Mailed to Veterans When
Necessary—Checklist—761—15 minutes
Frequency of Response: Annually.
Estimated Annual Responses:
a. Mailed with Veterans’ Initial
Letters—HEC Form 200–1A—178,002
b. Mailed with Spouses’ Initial
Letters—HEC Form 220–1—85,590
c. Mailed to Veterans When
Necessary—HEC Form 340–1—6,805
d. Mailed to Veterans When
Necessary—Checklist—761—3,044
By direction of the Secretary.
Cynthia Harvey-Pryor,
Program Specialist, Office of Privacy and
Records Management, Department of
Veterans Affairs.
[FR Doc. 2017–01753 Filed 1–25–17; 8:45 am]
BILLING CODE 8320–01–P

DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0342]

Agency Information Collection
Activity: (Application and Training
Agreement for Apprenticeship and Onthe-Job Training Programs) (VA Form
22–8864; 22–8865))
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

SUMMARY:

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8567

extension of a currently approved
collection, and allow 60 days for public
comment in response to the notice. This
notice solicits comments on information
needed to determine that training
programs (Apprenticeship and On-theJob Training) and agreements meet the
statutory requirements for approval.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before March 27, 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
nancy.kessinger@va.gov. Please refer to
‘‘OMB Control No. 2900–0342’’ 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 (Pub. L. 104–13; 44 U.S.C.
3501–21), 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.
Title: Application and Training
Agreement for Apprenticeship and Onthe-Job Training Programs, VA Form
22–8864; 22–8865.
OMB Control Number: 2900–0342.
Type of Review: Revision of a
currently approved collection.
Abstract: VA Forms 22–8864 and 22–
8865 are used to collect information
from employers and trainees to ensure
that training programs (Apprenticeship
and On-the-Job Training) and

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Federal Register / Vol. 82, No. 16 / Thursday, January 26, 2017 / Notices

agreements meet the statutory
requirements for approval.
Affected Public: Individuals or
household or small businesses/other
small entities.
Estimated Annual Burden: 19,535
hours.
Estimated Average Burden per
Respondent: 75 minutes.
Frequency of Response: Once.
Estimated Number of Respondents:
15,628.

BILLING CODE 8320–01–P

DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0802]

Agency Information Collection
Activity: Shoulder and Arm Conditions
Disability Benefits Questionnaire (VA
Form 21–0960M–12)
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.
VA Forms 21–0960M–12 is used to
gather necessary information from a
claimant’s treating physician regarding
the results of medical examinations.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before March 27, 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
nancy.kessinger@va.gov. Please refer to
‘‘OMB Control No. 2900–0802’’ in any
correspondence. During the comment

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15:10 Jan 25, 2017

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FOR FURTHER INFORMATION CONTACT:

[OMB Control No. 2900–0576]

SUPPLEMENTARY INFORMATION:

[FR Doc. 2017–01748 Filed 1–25–17; 8:45 am]

VerDate Sep<11>2014

DEPARTMENT OF VETERANS
AFFAIRS

Nancy J. Kessinger at (202) 632–8924 or
FAX (202) 632–8925.

By direction of the Secretary.
Cynthia Harvey-Pryor,
Agency Clearance Officer, Office of Privacy
and Records Management, Department of
Veterans Affairs.

SUMMARY:

period, comments may be viewed online
through the FDMS.

Under the PRA of 1995 (Public Law
104–13; 44 U.S.C. 3501–21), 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.
Title: (Shoulder and Arm Conditions
Disability Benefits Questionnaire (VA
Form 21–0960M–12).
OMB Control Number: 2900–0802.
Type of Review: Extension of an
approved collection.
Abstract: VA Forms 21–0960M–12 is
used to gather necessary information
from a claimant’s treating physician
regarding the results of medical
examinations.
Affected Public: Individuals or
households.
Estimated Annual Burden: 25,000
hours.
Estimated Average Burden per
Respondent: 30 minutes.
Frequency of Response: One time.
Estimated Number of Respondents:
50,000 per year.
By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Office of
Privacy and Records Management,
Department of Veterans Affairs.
[FR Doc. 2017–01751 Filed 1–25–17; 8:45 am]
BILLING CODE 8320–01–P

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Agency Information Collection
Activity: Certification of Affirmation of
Enrollment Agreement
Correspondence Course (VA Form 22–
1999c)
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. This
notice solicits comments on information
needed to determine a claimant’s
entitlement to educational assistance.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before March 27, 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
nancy.kessinger@va.gov. Please refer to
‘‘OMB Control No. 2900–0576’’ 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 (Pub. L. 104–13; 44 U.S.C.
3501–21), 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;
SUMMARY:

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