60-Day FRN (2900-0114), VAF21-4170)

2024-09321, 60-Day FRN (VAF21-4170).pdf

Statement of Marital Relationship (VA Form 21-4170)

60-Day FRN (2900-0114), VAF21-4170)

OMB: 2900-0114

Document [pdf]
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Federal Register / Vol. 89, No. 85 / Wednesday, May 1, 2024 / Notices
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.
Written comments and
recommendations for the proposed
information collection should be sent
within 30 days of publication of this
notice to www.reginfo.gov/public/do/
PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review—Open
for Public Comments’’ or by using the
search function. Refer to ‘‘OMB Control
No. 2900–0545’’.
FOR FURTHER INFORMATION CONTACT:
Maribel Aponte, Office of Enterprise
and Integration, Data Governance
Analytics (008), 810 Vermont Ave. NW,
Washington, DC 20420, (202) 266–4688
or email maribel.aponte@va.gov. Please
refer to ‘‘OMB Control No. 2900–0545’’
in any correspondence.
SUPPLEMENTARY INFORMATION:
Authority: 38 U.S.C. 1503, 28 CFR
3.262, § 3.271, and § 3.272.
Title: Report of Medical, Legal, and
Other Expenses Incident to Recovery for
Injury or Death.
OMB Control Number: 2900–0545.
Type of Review: Revision of a
currently approved collection.
Abstract: VA Form 21P–8416b is used
to gather information about certain
expenses related to securing
compensation based on personal injury
or death. The form is used by claimants
for VA income-based benefits to
determine the amount of countable
income. Without this information, the
VA would be unable to properly
determine entitlement to income-based
benefits and the rate payable.
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 at 89 FR
14154 on Friday, February 26, 2024,
page 14154.
Affected Public: Individuals or
Households.
Estimated Annual Burden: 75 hours.
Estimated Average Burden per
Respondent: 45 minutes.
Frequency of Response: One time.
Estimated Number of Respondents:
100.

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By direction of the Secretary.
Maribel Aponte,
VA PRA Clearance Officer, Office of
Enterprise and Integration, Data Governance
Analytics, Department of Veterans Affairs.
[FR Doc. 2024–09379 Filed 4–30–24; 8:45 am]
BILLING CODE 8320–01–P

DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0114]

Agency Information Collection
Activity: Statement of Marital
Relationship
Veterans Benefits
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:

Veterans Benefits
Administration, 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.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before July 1, 2024.
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. 2900–0114’’ in any
correspondence. During the comment
period, comments may be viewed online
through FDMS.
FOR FURTHER INFORMATION CONTACT:
Maribel Aponte, Office of Enterprise
and Integration, Data Governance
Analytics (008), 810 Vermont Ave. NW,
Washington, DC 20006, (202) 266–4688
or email maribel.aponte@va.gov. Please
refer to ‘‘OMB Control No. 2900–0114’’
in any correspondence.
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
SUMMARY:

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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: 38 U.S.C. 101(3), 38 U.S.C.
101(31), 38 U.S.C. 103(c).
Title: Statement of Marital
Relationship (VA Form 21–4170).
OMB Control Number: 2900–0114.
Type of Review: Revision of a
currently approved collection.
Abstract: VA Form 21–4170 is
primarily used to gather information
that is necessary to determine whether
a valid common law marriage was
established. The form is used by persons
claiming to be common law widows/
widowers of deceased veterans and by
veterans and their claimed common law
spouses. Benefits cannot be authorized
unless a valid marriage is established.
No changes have been made to this
form. The respondent burden has
decreased due to the estimated number
of receivables averaged over the past
year.
Affected Public: Individuals or
Households.
Estimated Annual Burden: 827 hours.
Estimated Average Burden per
Respondent: 25 minutes.
Frequency of Response: One time.
Estimated Number of Respondents:
1,984 per year.
By direction of the Secretary.
Maribel Aponte,
VA PRA Clearance Officer, Office of
Enterprise and Integration/Data Governance
Analytics, Department of Veterans Affairs.
[FR Doc. 2024–09321 Filed 4–30–24; 8:45 am]
BILLING CODE 8320–01–P

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