[Federal Register Volume 79, Number 123 (Thursday, June 26, 2014)]
[Notices]
[Page 36383]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-14949]



[[Page 36383]]

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DEPARTMENT OF VETERANS AFFAIRS

 [OMB Control No. 2900--NEW]


Agency Information Collection (Statement in Support of Claim for 
Disability and Related Compensation Benefits Due to Exposure) Activity 
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, 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 28, 2014.

ADDRESSES: Submit written comments on the collection of information 
through www.Regulations.gov, or to Office of Information and Regulatory 
Affairs, Office of Management and Budget, Attn: VA Desk Officer; 725 
17th St. NW., Washington, DC 20503 or sent through electronic mail to 
[email protected]. Please refer to ``OMB Control No. 2900--
NEW (Statement in Support of Claim for Disability and Related 
Compensation Benefits Due to Exposure)'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records 
Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue 
NW., Washington, DC 20420, (202) 632-7492 or email 
[email protected]. Please refer to ``OMB Control No. 2900--NEW 
(Statement in Support of Claim for Disability and Related Compensation 
Benefits Due to Exposure).''

SUPPLEMENTARY INFORMATION: 
    Title: Statement in Support of Claim for Disability and Related 
Compensation Benefits Due to Exposure Due to Exposure (VA Form 21-
0964).
    OMB Control Number: 2900--NEW.
    Type of Review: New collection.
    Abstract: VA will use the information collected on VA Form 21-0964 
to gather information related to exposure. The form will be used to 
determine if a veteran has been exposed for the purposes 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 April 16, 2014, at pages 21518-21519.
    Affected Public: Individuals and Households.
    Estimated Annual Burden: 20,000 hours.
    Estimated Average Burden per Respondent: 20 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents: 6,667.

    Dated: June 23, 2014.

    By direction of the Secretary.
Crystal Rennie,
Department Clearance Officer, Department of Veterans Affairs.
[FR Doc. 2014-14949 Filed 6-25-14; 8:45 am]
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