[Federal Register Volume 77, Number 124 (Wednesday, June 27, 2012)]
[Notices]
[Pages 38397-38398]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-15657]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0734]


Agency Information Collection (Report of General Information) 
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, Department of Veterans Affairs, will submit 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 27, 2012.

ADDRESSES: Submit written comments on the collection of information 
through www.Regulations.gov or 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. 2900-0734.

FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records 
Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue 
NW., Washington, DC 20420, (202) 632-7479, Fax (202) 632-7583 or email 
[email protected]. Please refer to ``OMB Control No. 2900-0734.''

SUPPLEMENTARY INFORMATION: 
    Titles:
    a. VA Form 21-0820, Report of General Information.
    b. VA Form 21-0820a, Report of Death of Beneficiary.
    c. VA Form 21-0820b, Report of Nursing Home Information.
    d. VA Form 21-0820c, Report of Defense Finance and Accounting 
Service (DFAS).
    e. VA Form 21-0820d, Report of Lost Check.
    f. VA Form 21-0820e, Report of Incarceration.

[[Page 38398]]

    g. VA Form 21-0820f, Month of Death Check.
    OMB Control Number: 2900-0734.
    Type of Review: Extension of currently approved collection.
    Abstract: The forms will be used by VA personnel to document verbal 
information obtained telephonically from claimants or their 
beneficiary. The data collected will be used as part of the evidence 
needed to determine the claimant's or beneficiary's eligibility for 
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 April 18, 2012, at page 23322.
    Affected Public: Federal Government.
    Estimated Annual Burden:
    a. VA Form 21-0820, Report of General Information--19,667.
    b. VA Form 21-0820a, Report of Death of Beneficiary--6,667.
    c. VA Form 21-0820b, Report of Nursing Home Information--2,500.
    d. VA Form 21-0820c, Report of Defense Finance and Accounting 
Service (DFAS)--2,500.
    e. VA Form 21-0820d, Report of Lost Check--2,500.
    f. VA Form 21-0820e, Report of Incarceration--833.
    g. VA Form 21-0820f, Month of Death Check--833.
    Estimated Average Burden per Respondent: 5 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents:
    a. VA Form 21-0820, Report of General Information--2,360,000.
    b. VA Form 21-0820a, Report of Death of Beneficiary--80,000.
    c. VA Form 21-0820b, Report of Nursing Home Information--30,000.
    d. VA Form 21-0820c, Report of Defense Finance and Accounting 
Service (DFAS)--30,000.
    e. VA Form 21-0820d, Report of Lost Check--30,000.
    f. VA Form 21-0820e, Report of Incarceration--10,000.
    g. VA Form 21-0820f, Month of Death Check- 10,000.

    Dated: June 22, 2012.

    By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2012-15657 Filed 6-26-12; 8:45 am]
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