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Agency Information Collection Activities Under OMB Review

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Information about this document as published in the Federal Register.

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This document has been published in the Federal Register. Use the PDF linked in the document sidebar for the official electronic format.

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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 April 27, 2005.

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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 Please refer to “OMB Control No. 2900-NEW.” 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-NEW” in any correspondence

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a. Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder (PTSD), VA Form 21-0781.

b. Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder (PTSD) Secondary to Personal Assault, VA Form 21-0781a.

OMB Control Number: 2900-NEW.

Type of Review: New collection.

Abstract: Veterans seeking compensation for post-traumatic stress disorder and need VA's assistance in obtaining evidence from military records and other sources to substantiate their claims of in-service stressors must complete VA Forms 21-0781 and 21-0791a. If the veteran did not serve in combat or was not a prisoner of war and is claiming compensation for post-traumatic stress disorder due to in-service stressors, he or she must provide credible supporting evidence that the claimed in-service stressor occurred.

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 December 1, 2004 at pages 69990-6991.

Affected Public: Individuals or households.

Estimated Annual Burden: 17,780 hours.

Estimated Average Burden Per Respondent: 70 minutes.

Frequency of Response: One-time.

Estimated Number of Respondents: 15,240.

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Dated: March 17, 2005.

By direction of the Secretary.

Martin Hill,

Management Analyst, Records Management Service.

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[FR Doc. E5-1330 Filed 3-25-05; 8:45 am]