[Federal Register Volume 69, Number 37 (Wednesday, February 25, 2004)]
[Notices]
[Pages 8745-8746]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-4102]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0616]


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. 3501-21), this notice announces that the Veterans Health 
Administration (VHA), Department of Veteran 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 and includes the actual data collection instrument.

DATES: Comments must be submitted on or before March 26, 2004.

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. 2900-0616.''
    Send comments and recommendations concerning any aspect of the 
information collection to VA's OMB Desk Officer, OMB Human Resources 
and Housing Branch, 0616'' in any correspondence.

[[Page 8746]]


FOR FURTHER INFORMATION CONTACT: Ann W. Bickoff (202) 273-8310 or FAX 
(202) 273-9381.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Public Law 104-13; 44 
U.S.C. 3501--3521), Federal agencies must obtain approval from the 
Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. This request for comment is being 
made pursuant to section 3506(c)(2)(A) of the PRA.
    With respect to the following collection of information, VHA 
invites comments on: (1) Whether the proposed collection of information 
is necessary for the proper performance of VHA's functions, including 
whether the information will have practical utility; (2) the accuracy 
of VHA's estimate of the burden of the proposed collection of 
information; (3) ways to enhance the quality, utility, and clarity of 
the information to be collected; and (4) ways to minimize the burden of 
the collection of information on respondents, including through the use 
of automated collection techniques or the use of other forms of 
information technology.
    Titles:
    a. Application for Furnishing Nursing Home Care to Beneficiaries of 
Veterans Affairs, VA Form 10-1170.
    b. Residential Care Home Program--Sponsor Application, VA Form 10-
2407.
    OMB Control Number: 2900-0616.
    Type of Review: Extension of a currently approved collection.
    Abstract:
    a. VA Form 10-1170 is an application used by nursing homes wishing 
to provide nursing home care to veterans who receive VA benefits.
    b. VA Form 10-2407 is an application used by a residential care 
facility or home that wishes to provide residential home care to 
veterans. It serves as the agreement between VA and the residential 
care home that the home will submit to an initial inspection and comply 
with VA requirements for residential care.
    Affected Public: Business or other for-profit, Not-for-profit 
institutions, and State, Local or Tribal Government.
    Estimated Annual Burden:
    a. VA Form 10-1170-167 hours.
    b. VA Form 10-2407-83 hours.
    Estimated Average Burden Per Respondent:
    a. VA Form 10-1170-20 minutes.
    b. VA Form 10-2407-5 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents:
    a. VA Form 10-1170-500.
    b. VA Form 10-2407-1,000.

    Dated: February 17, 2004.

    By direction of the Secretary.
Loise Russell,
Director, Records Management Service.
[FR Doc. 04-4102 Filed 2-24-04; 8:45 am]
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