This PDF is the current document as it appeared on Public Inspection on 09/12/2012 at 08:45 am.
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, will submit 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 October 15, 2012.
Submit written comments on the collection of information through www.Regulations.gov or to VA's OMB Desk Officer, Office of Information and Regulatory Affairs, New Executive Office Building, Room 10235, Washington, DC 20503 (202) 395-7316. Please refer to “OMB Control No. 2900-0319” in any correspondence.
FOR FURTHER INFORMATION CONTACT:
Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632-7479, Fax (202) 632-7583 or email firstname.lastname@example.org. Please refer to “OMB Control No. 2900-0319.”
Title: Fiduciary Agreement, VA Form 21-4703.
OMB Control Number: 2900-0319.
Type of Review: Extension of a currently approved collection.
Abstract: VA Form 21-4703 is a legal binding contract between VA and Federally appointed fiduciaries receiving VA funds on behalf beneficiaries who were determined to be incompetent or under legal disability by reason of minority or court action. The form outlines the fiduciary's responsibility regarding the use of VA funds.
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 July 2, 2012, at pages 39345-39346.
Affected Public: Individuals or households.
Estimated Annual Burden: 1,467 hours.
Estimated Average Burden per Respondent: 5 minutes.
Frequency of Response: One time.
Estimated Number of Respondents: 17,600.
By direction of the Secretary.
Dated: September 7, 2012.
Program Analyst, Enterprise Records Service.
[FR Doc. 2012-22496 Filed 9-12-12; 8:45 am]
BILLING CODE 8320-01-P