Veterans Benefits Administration, 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 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 19, 2006.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. 2900-0104.”
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. 2900-0104” in any correspondence.End Further Info End Preamble Start Supplemental Information
Title: Report of Accidental Injury in Support of Claim for Compensation or Pension, VA Form 21-4176, Parts A & B.
OMB Control Number: 2900-0104.
Type of Review: Extension of a currently approved collection.
Abstract: The data collected on VA Form 21-4176 is used to determine a veteran's eligibility for disability benefits based on an accidental injury that he or she incurred while in the line of duty. VA uses the information collected to determine whether the injury was the result of a willful misconduct by the veteran.
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 October 25, 2005 at page 61695.
Affected Public: Individuals or households.
Estimated Annual Burden: 2,204 hours.
Estimated Average Burden Per Respondent: 30 minutes.
Frequency of Response: One-time.
Estimated Number of Respondents: 4,408.Start Signature
Dated: March 8, 2006.
By direction of the Secretary.
Program Analyst, Records Management Service.
[FR Doc. E6-4003 Filed 3-17-06; 8:45 am]
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