Office of Information and Technology, Department of Veterans Affairs.
In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-21), this notice announces that the Veterans Health Administration (VHA), 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 and includes the actual data collection instrument.
Comments must be submitted on or before November 21, 2005.Start Further Info
FOR FURTHER INFORMATION OR A COPY OF THE SUBMISSION CONTACT:
Denise McLamb, Records Management Service (005E3), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 565-8374, FAX (202) 565-6950 or e-mail: firstname.lastname@example.org. Please refer to “OMB Control No. 2900-0028”.
Send comments and recommendations concerning any aspect of the information collection to VA's 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. 2900-0028”.End Further Info End Preamble Start Supplemental Information
a. Application of Service Representative for Placement on Mailing List, VA Form 3215.
b. Request for and Consent to Release of Information from Claimant's Records, VA Form 3288.
c. Request to Correspondent for Identifying Information, VA Form Letter 70-2.
d. 38 CFR 1.519(A) Lists of Names and Addresses.
OMB Control Number: 2900-0028.
Type of Review: Extension of a currently approved collection.
a. VA operates an outreach services program to ensure veterans and beneficiaries have information about benefits and services to which they may be entitled. To support the program, VA Start Printed Page 61174distributes copies of publications to Veterans Service Organizations' representatives to be used in rendering services and representation of veterans, their spouses and dependents. Service organizations complete VA Form 3215 to request placement on a mailing list for specific VA publications.
b. Veterans or beneficiaries complete VA Form 3288 to provide VA with a written consent to release his or her records or information to third parties such as insurance companies, physicians and other individuals.
c. VA Form Letter 70-2 is used to obtain additional information from a correspondent when the incoming correspondence does not provide sufficient information to identify a veteran. VA personnel use the information to identify the veteran, determine the location of a specific file, and to accomplish the action requested by the correspondent such as processing a benefit claim or file material in the individual's claims folder.
d. Title 38 U.S.C.5701(f)(1) authorized the disclosure of names or addresses, or both of present or former members of the Armed Forces and/or their beneficiaries to nonprofit organizations (including members of Congress) to notify veterans of Title 38 benefits and to provide assistance to veterans in obtaining these benefits. This release includes VA's Outreach Program for the purpose of advising veterans of non-VA Federal, State and local benefits and programs.
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 June 30, 2005, at pages 37898-37899.
Affected Public: Individuals or Households, Not for Profit Institutions, and State, Local or Tribal Government.
Estimated Annual Burden: 22,700 hours.
a. Application of Service Representative for Placement on Mailing List, VA Form 3215—25 hours.
b. Request for and Consent to Release of Information From Claimant's Records, VA Form 3288—18,875 hours.
c. Request to Correspondent for Identifying Information, VA Form Letter 70-2—3,750 hours.
d. 38 CFR(A) 1.519 Lists of Names and Addresses—50 hours.
Estimated Average Burden Per Respondent:
a. Application of Service Representative for Placement on Mailing List, VA Form 3215—10 minutes.
b. Request for and Consent to Release of Information From Claimant's Records, VA Form 3288—7.5 minutes.
c. Request to Correspondent for Identifying Information, VA Form Letter 70-2—5 minutes.
d. 38 CFR(A) 1.519 Lists of Names and Addresses—60 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents: 196,200.
a. Application of Service Representative for Placement on Mailing List, VA Form 3215—150.
b. Request for and Consent to Release of Information from Claimant's Records, VA Form 3288—151,000.
c. Request to Correspondent for Identifying Information, VA Form Letter 70-2—45,000.
d. 38 CFR(A) 1.519 Lists of Names and Addresses—50.Start Signature
Dated: October 6, 2005.
By direction of the Secretary.
Program Analyst, Records Management Service.
[FR Doc. E5-5781 Filed 10-19-05; 8:45 am]
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