[Federal Register Volume 60, Number 169 (Thursday, August 31, 1995)]
[Notices]
[Pages 45521-45522]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-21595]



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DEPARTMENT OF VETERANS AFFAIRS

Information Collections Under OMB Review

AGENCY: Veterans Benefits Administration, Department of Veterans 
Affairs.

ACTION: Notice.

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SUMMARY: The Veterans Benefits Administration (VBA), Department of 
Veterans Affairs, has submitted to the Office of Management and Budget 
(OMB) the following proposals for the collection of information under 
the provisions of the Paperwork Reduction Act (44 U.S.C. Chapter 35).

OMB Number: 2900-0065
Title and Form Number: Request for Employment Information in Connection 
with Claim for Disability Benefits, VA Form 21-4192.
Type of Information Collection: Extension of a currently approved 
collection.
Needs and Uses: The form is used to gather the necessary information 
about employment of the veteran-applicant to determine the extent of 
disability affecting employment.
Affected Public: Business or other for-profit.
Estimated Annual Burden: 15,000 hours.
Estimated Average Burden Per Respondent: 15 minutes.
Frequency of Response: One time.
Estimated Number of Respondents: 60,000 respondents.

OMB Number: 2900-0075
Title and Form Number: Statement in Support of Claim, VA Form 21-4138.
Type of Information Collection: Extension of a currently approved 
collection.
Needs and Uses: The form is used by the claimant to provide self-
certified statements in support of various types of claims processed by 
VBA.
Affected Public: Individuals or households.
Estimated Annual Burden: 188,000 hours.
Estimated Average Burden Per Respondent: 15 minutes.
Frequency of Response: One time.
Estimated Number of Respondents: 752,000 respondents.

OMB Number: 2900-0076
Title and Form Number: Request to Creditor Regarding Applicant's 
Indebtedness, VA Form Letter 26-250.
Type of Information Collection: Extension of a currently approved 
collection.
Needs and Uses: The form is completed by creditors of veteran-
applicants who are applying for a home loan. The information is used to 
determine the applicant's credit worthiness.

[[Page 45522]]

Affected Public: Business or other for-profit--Individuals or 
households.
Estimated Annual Burden: 10,833 hours.
Estimated Average Burden Per Respondent: 10 minutes.
Frequency of Response: One time.
Estimated Number of Respondents: 65,000 respondents.

OMB Number: 2900-0089
Title and Form Number: Statement of Dependency of Parent(s), VA Form 
21-509.
Type of Information Collection: Extension of a currently approved 
collection.
Needs and Uses: The form is used to gather income and dependency 
information from applicants who are seeking payment of benefits as or 
for a dependent parent. The information is used to determine dependency 
of the parent.
Affected Public: Individuals or households.
Estimated Annual Burden: 20,000 hours.
Estimated Average Burden Per Respondent: 30 minutes.
Frequency of Response: One time.
Estimated Number of Respondents: 40,000 respondents.

OMB Number: 2900-0095
Title and Form Number: Pension Claim Questionnaire for Farm Income, VA 
Form 21-4165.
Type of Information Collection: Extension of a currently approved 
collection.
Needs and Uses: The form is used to develop the necessary income and 
asset information peculiar to farm operations. The information is used 
to determine whether the claimant is eligible for VA benefits and, if 
eligibility exists, it is used to determine the proper rate of 
benefits.
Affected Public: Farms--Individuals or households.
Estimated Annual Burden: 12,500 hours.
Estimated Average Burden Per Respondent: 30 minutes.
Frequency of Response: One time.
Estimated Number of Respondents: 25,000 respondents.

ADDRESSES: Copies of these submissions may be obtained from Trish 
Fineran, Veterans Benefits Administration (20M30), Department of 
Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 
273-6886.
    Comments and recommendations concerning the submissions should be 
directed to VA's OMB Desk Officer, Allison Eydt, OMB Human Resources 
and Housing Branch, New Executive Office Building, Room 10235, 
Washington, DC 20503, (202) 395-4650. Do not send requests for benefits 
to this address.

DATES: Comments on the information collections should be directed to 
the OMB Desk Officer on or before October 2, 1995.

FOR FURTHER INFORMATION CONTACT: Ron Taylor, VA Clearance Officer 
(045A4), (202) 565-4412.

    Dated: August 24, 1995.

    By direction of the Secretary.
Donald L. Neilson,
Director, Information Management Service.
[FR Doc. 95-21595 Filed 8-30-95; 8:45 am]
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