[Federal Register Volume 67, Number 221 (Friday, November 15, 2002)]
[Notices]
[Page 69306]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-28976]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0104]


Agency Information Collection Activities Under OMB Review

AGENCY: Veterans Benefits 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 
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.

DATES: Comments must be submitted on or before December 16, 2002.

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) 273-8030, 
FAX (202) 273-5981 or e-mail: [email protected]. 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.

SUPPLEMENTARY INFORMATION: 
    Title: Report of Accidental Injury in Support of Claim for 
Compensation or Pension, VA Form 21-4176.
    OMB Control Number: 2900-0104.
    Type of Review: Extension of a currently approved collection.
    Abstract: The form is used in support of claims for disability 
benefits based on disability which is the result of an accident. The 
information given by the veteran is used as a source to gather specific 
data regarding the accident and to afford the veteran an opportunity to 
provide information from his or her own knowledge regarding the 
accident. Benefits may be paid if a disability is incurred in line of 
duty and is not the result of the veteran's own willful misconduct.
    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 August 23, 2002, at pages 54697-54698.
    Affected Public: Individuals or households.
    Estimated Annual Burden: 2,200 hours.
    Estimated Average Burden Per Respondent: 30 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents: 4,400.

    Dated: November 6, 2002.

    By direction of the Secretary.
Loise Russell,
Acting Director, Records Management Service.
[FR Doc. 02-28976 Filed 11-14-02; 8:45 am]
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