[Federal Register Volume 66, Number 162 (Tuesday, August 21, 2001)]
[Notices]
[Pages 43959-43960]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-20989]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0188]


Agency Information Collection Activities Under OMB Review

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 
(44 U.S.C., 3501 et seq.), 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; it includes the actual data collection 
instrument.

DATES: Comments must be submitted on or before September 20, 2001.

FOR FURTHER INFORMATION OR A COPY OF THE SUBMISSION CONTACT: Denise 
McLamb, Information Management Service (045A4), Department of Veterans 
Affairs, 810 Vermont Avenue, NW, Washington, DC 20420, (202) 273-8030 
or FAX (202) 273-5981 or e-mail [email protected]. Please refer 
to ``OMB Control No. 2900-0188.''

SUPPLEMENTARY INFORMATION:
    Titles:

a. Request to Submit Estimate, Form Letter 10-90.
b. Loan Follow-up Letter, Form Letter 10-426.
c. Veterans Application for Assistance in Acquiring Home Improvement 
and Structural Alterations, VA Form 10-0103.
d. Application for Adaptive Equipment Motor Vehicle, VA Form 10-1394.
e. Prosthetic Authorization for Items or Services, VA Form 10-2421.
f. Prosthetic Service Card Invoice, VA Form 10-2520.
g. Prescription and Authorization for Eyeglasses, VA Form 10-2914.

    OMB Control Number: 2900-0188.
    Type of Review: Extension of a currently approved collection.
    Abstract:
    a. Form Letter 10-90 is prepared by the VHA and issued to a 
contractor of the veteran's choice in order to solicit a price quote 
for a prosthetic device.
    b. Form Letter 10-426 is used to inventory prosthetic devices 
loaned to eligible veterans. The form letter inventories the loaned 
items and solicits information from the beneficiary to determine the 
current status, the need to replace, extend the loan period or 
terminate the loaned items.
    c. VA Form 10-0103 is used to determine eligibility/entitlement and 
reimbursement of individual claims for home improvement and structural 
alterations.
    d. VA Form 10-1394 is used to determine eligibility/entitlement and 
reimbursement of individual claims for automotive adaptive equipment.
    e. VA Form 10-2421 is used for the direct procurement of new 
prosthetic appliances and/or services and standardizes the direct 
procurement authorization process. The form eliminates the need for 
separate purchase orders, expedites patient treatment and improves the 
delivery of prosthetic services.
    f. VA Form 10-2520 is used by the commercial vendors after 
completing repairs authorized for veterans by their Prosthetic Service 
Card to request payment by VA. The form standardizes repair/treatment 
invoices for prosthetic services rendered and standardizes the 
verification of these invoices. The veteran certifies that the repairs 
were necessary and satisfactory. This form is furnished to vendors upon 
request.
    g. VA Form 10-2914 is used as a combination prescription, 
authorization and invoice. It allows veterans to purchase their 
eyeglasses directly. If the form is not used, the provisions of 
providing eyeglasses to eligible veterans may be delayed.
    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 May 31, 2001, at pages 29632-29633.
    Affected Public: Business or other for profit and Individuals or 
households.
    Estimated Total Annual Burden: 37,079 hours.

a. Form Letter 10-90--1,875.
b. Form Letter 10-426--242.
c. VA Form 10-0103--583.
d. VA Form 10-1394--2,711.
e. VA Form 10-2421--16,667.
f. VA Form 10-2520--3,334.
g. VA Form 10-2914--11,667.
    Estimated Average Burden Per Respondent:

a. Form Letter 10-90--5 minutes.
b. Form Letter 10-426--1 minute.
c. VA Form 10-0103--5 minutes.
d. VA Form 10-1394--15 minutes.
e. VA Form 10-2421--4 minutes.
f. VA Form 10-2520--5 minutes.
g. VA Form 10-2914--4 minutes.

    Frequency of Response: On occasion.
    Estimated Number of Respondents: 519,844.

a. Form Letter 10-90--22,500.
b. Form Letter 10-426--14,500.
c. VA Form 10-0103--7,000.
d. VA Form 10-1394--10,844.
e. VA Form 10-2421--250,000.
f. VA Form 10-2520--40,000.
g. VA Form 10-2914--175,000.

    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. 
2900-0188'' in any correspondence.

    Dated: August 10, 2001.


[[Page 43960]]


    By direction of the Secretary.
Donald L. Neilson,
Director, Information Management Service.
[FR Doc. 01-20989 Filed 8-20-01; 8:45 am]
BILLING CODE 8320-01-P