[Federal Register Volume 69, Number 211 (Tuesday, November 2, 2004)]
[Notices]
[Page 63571]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-24399]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0095]


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. 3501-3521), 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 2, 2004.

FOR FURTHER INFORMATION 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-
0095.''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. 
2900-0095'' in any correspondence.

SUPPLEMENTARY INFORMATION: 
    Title: Pension Claim Questionnaire for Farm Income, VA Form 21-
4165.
    OMB Control Number: 2900-0095.
    Type of Review: Extension of a currently approved collection.
    Abstract: VA Form 21-4165 is used to gather information necessary 
to determine a claimant's countable annual income and available assets 
due to farm operations. Eligibility to income-based benefits cannot be 
determined without complete information about a claimant's income. Farm 
income is not necessarily received on a weekly or monthly basis, and 
farm operating expenses must be considered in determining income and 
total assets. If eligibility exists, the information will be used to 
determine the proper rate of benefits.
    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 June 15, 2004, at page 33466.
    Affected Public: Individuals or households and farms.
    Estimated Annual Burden: 1,038 hours.
    Estimated Average Burden per Respondent: 30 minutes.
    Frequency of Response: Annually.
    Estimated Number of Respondents: 2,075.

    Dated: October 19, 2004.

    By direction of the Secretary.
Loise Russell,
Director, Records Management Service.
[FR Doc. 04-24399 Filed 11-1-04; 8:45 am]
BILLING CODE 8320-01-P