[Federal Register Volume 81, Number 194 (Thursday, October 6, 2016)]
[Notices]
[Page 69574]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-24159]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0798]


Proposed Information Collection (Beneficiary Travel Mileage 
Reimbursement Application Form, VA Form 10-3542) Activity: 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. 3501-3521), this notice announces that the Veterans Health 
Administration (VHA), 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 November 7, 2016.

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-
0798'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor, Enterprise 
Records Service (005R1B), Department of Veterans Affairs, 810 Vermont 
Avenue NW., Washington, DC 20420, (202) 461-5870 or email 
[email protected]. Please refer to ``OMB Control No. 2900-
0798.''

SUPPLEMENTARY INFORMATION: 
    Title: Beneficiary Travel Mileage Reimbursement Application Form.
    OMB Control Number: 2900-0798.
    Type of Review: Extension of a Currently Approved Collection.
    Abstract: The information collection is for beneficiaries to apply 
for the BT mileage reimbursement benefit. VHA determines the identity 
of the claimant, the dates and length of the trip being claimed based 
on addresses of starting and ending points, and whether expenses other 
than mileage are being claimed. The claimant is required to sign the 
form. The form is used only when the claimant chooses not to apply 
verbally and is provided for their convenience. Once the information is 
obtained it is entered into a software program that calculates the 
mileage and resulting reimbursement. The Federal Register Notice with a 
60-day comment period soliciting comments on this collection of 
information was published at Vol. 81, No. 129, Friday, July 6, 2016
    Affected Public: Individuals or households.
    Estimated Annual Burden: 580,000 hours.
    Estimated Average Burden per Respondent: 3 minutes.
    Frequency of Response: 8 per year.
    Estimated Number of Respondents: 1,450,000.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Program Specialist, Office of Privacy and Records Management, 
Department of Veterans Affairs.
[FR Doc. 2016-24159 Filed 10-5-16; 8:45 am]
 BILLING CODE 8320-01-P