Veterans Benefits Administration, Department of Veterans Affairs.
In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice announces that the Veterans Benefits Administration (VBA), 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.
Comments must be submitted on or before September 29, 2004.Start Further Info
FOR FURTHER INFORMATION CONTACT:
Denise McLamb, Records Management Service (005E3), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 273-8030, FAX (202) 273-5981 or e-mail firstname.lastname@example.org. Please refer to “OMB Control No. 2900-0065.” Send comments and recommendations concerning any aspect of the information collection to VA's OMB Desk Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC 20503, (202) 395-7316. Please refer to “OMB Control No. 2900-0065” in any correspondence.End Further Info End Preamble Start Supplemental Information
Title: Request for Employment Information in Connection with Claim for Disability Benefits, VA Form 21-4192.
OMB Control Number: 2900-0065.
Type of Review: Extension of a currently approved collection.
Abstract: VA Form 21-4192 is used to request employment information from a claimant's employer. The collected data is used to determine the claimant's eligibility for increased disability benefits based on unemployability.
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, 2004, at page 18154.
Affected Public: Business or other for-profit.
Estimated Annual Burden: 15,000 hours.
Estimated Average Burden Per Respondent: 15 minutes.
Frequency of Response: One time.
Estimated Number of Respondents: 60,000.Start Signature
Dated: August 11, 2004.
By direction of the Secretary.
Program Analyst, Records Management Service.
[FR Doc. 04-19688 Filed 8-27-04; 8:45 am]
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