[Federal Register Volume 68, Number 22 (Monday, February 3, 2003)]
[Notices]
[Page 5342]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-2353]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0205]


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 March 5, 2003.

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. 2900-0205.''
    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. 
2900-0205'' in any correspondence.

SUPPLEMENTARY INFORMATION: Titles:
    a. VA Form 10-2850, Application for Physicians, Dentists, 
Podiatrists and Optometrists.
    b. VA Form 10-2850a, Application for Nurses and Nurse Anesthetists.
    c. VA Form 10-2850b, Application for Residents.
    d. VA Form 10-2850c, Application for Associated Health Occupations.
    e. VA Form FL 10-341a, Appraisal of Applicant.
    OMB Control Number: 2900-0205.
    Type of Review: Extension of a currently approved collection.
    Abstract: VA Forms 10-2850 and 10-2850a through c are applications 
designed specifically to elicit appropriate information about each 
candidate's qualifications for employment with VA. VHA officials use 
the information to evaluate education, professional experience and 
credentials and to determine suitability and grade level of 
applications of physicians, dentists, podiatrists, optometrists, nurses 
and nurse anesthetists, residents, and associated health occupations, 
and appraisal of applicants. The forms require disclosure of details 
about all licenses ever held, Drug Enforcement Administration 
certification, board certification, clinical privileges, revoked 
certification or registrations, liability insurance history, and 
involvement in malpractice proceedings. Form Letter 10-341a is a pre 
employment reference form used to elicit information concerning the 
prior education and/or performance of the Title 38 applicant.
    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 15, 2002, at pages 63733--63734.
    Affected Public: Individuals or Households, Business or other for-
profit, Not-for-profit institutions, Federal Government, State, Local 
or Tribal Government.
    Estimated Annual Burden: 75,471 hours.
    a. VA Form 10-2850, Application for Physicians, Dentists, 
Podiatrists and Optometrists--7,095 hours.
    b. VA Form 10-2850a, Application for Nurses and Nurse 
Anesthetists--28,380 hours.
    c. VA Form 10-2850b, Application for Residents--15,136 hours.
    d. VA Form 10-2850c, Application for Associated Health 
Occupations--9,460 hours.
    e. VA Form FL 10-341a, Appraisal of Applicant--15,400 hours.
    Estimated Average Burden Per Respondent: 27 minutes.
    a. VA Form 10-2850, Application for Physicians, Dentists, 
Podiatrists and Optometrists--30 minutes.
    b. VA Form 10-2850a, Application for Nurses and Nurse 
Anesthetists--30 minutes.
    c. VA Form 10-2850b, Application for Residents--30 minutes.
    d. VA Form 10-2850c, Application for Associated Health 
Occupations--30 minutes.
    e. VA Form FL 10-341a, Appraisal of Applicant--20 minutes.
    Frequency of Response: On Occasion.
    Estimated Number of Respondents: 166,342.
    a. VA Form 10-2850, Application for Physicians, Dentists, 
Podiatrists and Optometrists--14,190.
    b. VA Form 10-2850a, Application for Nurses and Nurse 
Anesthetists--56,760.
    c. VA Form 10-2850b, Application for Residents--30,272.
    d. VA Form 10-2850c, Application for Associated Health 
Occupations--18,920.
    e. VA Form FL 10-341a, Appraisal of Applicant--46,200.

    Dated: January 14, 2003.
    By direction of the Secretary.
Loise A. Russell,
Acting Director, Records Management Service.
[FR Doc. 03-2353 Filed 1-31-03; 8:45 am]
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