[Federal Register Volume 70, Number 119 (Wednesday, June 22, 2005)]
[Notices]
[Pages 36236-36237]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E5-3254]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0115]


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 July 22, 2005.

FOR FURTHER INFORMATION OR A COPY OF THE SUBMISSION CONTACT: Denise 
McLamb, Records Management Service (005E3), Department of Veterans 
Affairs, 8l0 Vermont Avenue, NW., Washington, DC 20420, (202) 273-8030, 
FAX (202) 273-5981 or e-mail: [email protected]. Please refer 
to ``OMB Control No. 2900-0115.''
    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. 
2900-0115'' in any correspondence.

SUPPLEMENTARY INFORMATION:
    Title: Supporting Statement Regarding Marriage, VA Form 21-4171.
    OMB Control Number: 2900-0115.
    Type of Review: Revision of a currently approved collection.
    Abstract: The data collected on VA Form 21-4172 is used to 
determine a claimant's eligibility for benefits based on a common law 
marital relationship. Benefits cannot be pay unless the marital 
relationship between the claimant and the veteran is established.
    An agency may not conduct or sponsor, and a person is not required 
to

[[Page 36237]]

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 February 4, 2005, at page 6077.
    Affected Public: Individuals or households.
    Estimated Annual Burden: 800 hours.
    Estimated Average Burden Per Respondent: 20 minutes.
    Frequency of Response: One-time.
    Estimated Number of Respondents: 2,400.

    Dated: June 13, 2005.

    By direction of the Secretary.
Loise Russell,
Director, Records Management Service.
[FR Doc. E5-3254 Filed 6-21-05; 8:45 am]
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