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 July 22, 2005.Start Further Info
FOR FURTHER INFORMATION OR A COPY OF THE SUBMISSION CONTACT:
Denise McLamb, Records Management Service (005E3), Department of Veterans Affairs, 8l0 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. 2900-0115.”
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. 2900-0115” in any correspondence.End Further Info End Preamble Start Supplemental Information
Title: Supporting Statement Regarding Marriage, VA Form 21-4171.
OMB Control Number: 2900-0115.
Type of Review: Revision of a currently approved collection.
Abstract: The data collected on VA Form 21-4172 is used to determine a claimant's eligibility for benefits based on a common law marital relationship. Benefits cannot be pay unless the marital relationship between the claimant and the veteran is established.
An agency may not conduct or sponsor, and a person is not required to Start Printed Page 36237respond 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 February 4, 2005, at page 6077.
Affected Public: Individuals or households.
Estimated Annual Burden: 800 hours.
Estimated Average Burden Per Respondent: 20 minutes.
Frequency of Response: One-time.
Estimated Number of Respondents: 2,400.Start Signature
Dated: June 13, 2005.
By direction of the Secretary.
Director, Records Management Service.
[FR Doc. E5-3254 Filed 6-21-05; 8:45 am]
BILLING CODE 8320-01-P