[Federal Register Volume 81, Number 238 (Monday, December 12, 2016)]
[Notices]
[Pages 89576-89577]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-29667]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0793]


Agency Information Collection Activity Under OMB Review: (VA 
Health Professional Scholarship and Visual Impairment and Orientation 
and Mobility Professional Scholarship Programs)

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 January 11, 2017.

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-
0793'' 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-
0793.''

SUPPLEMENTARY INFORMATION:

Titles

    1. Academic Verification, VA Form 10-0491.
    2. Addendum to Application, VA Form 10-0491a.
    3. Annual VA Employment Deferment Verification, VA Form 10-0491c.
    4. Education Program Completion Notice Service Obligation 
Placement, VA Form 10-0491d.
    5. Evaluation Recommendation Form, VA Form 10-0491e.
    6. HPSP Agreement, VA Form 10-0491f.
    7. HPSP/OMPSP Application, VA Form 10-0491g.
    8. Notice of Approaching Graduation, VA Form 10-0491h.
    9. Notice of Change and/or Annual Academic Status Report, VA Form 
10-0491i.
    10. Request for Deferment for Advanced Education, VA Form 10-0491j.
    11. VA Scholarship Offer Response, VA Form 10-0491k.
    12. VIOMPSP Agreement, VA Form 10-0491l.
    OMB Control Number: 2900-0793.
    Type of Review: Revision of a currently approved collection.

Abstract

    The information required determines the eligibility or suitability 
of an applicant desiring to receive an award under the provisions of 38 
U.S.C. 7601 through 7619, and 38 U.S.C. 7501 through 7505. The 
information is needed to apply for the VA Health Professional 
Scholarship Program or Visual Impairment and Orientation and Mobility 
Professional Scholarship Program. The VA Health Professional 
Scholarship Program awards scholarships to students receiving education 
or training in a direct or indirect healthcare services discipline to 
assist in providing an adequate supply of such personnel for VA and for 
the United States. The Visual Impairment and Orientation and Mobility 
Professional Scholarship Program awards scholarships to students 
pursuing a program of study leading to a degree in visual impairment or 
orientation and mobility in order to increase the supply of qualified 
blind rehabilitation specialists for VA and the Nation. The Federal 
Register Notice with a 60-day comment period soliciting comments on 
this collection of information was published at Vol. 81, No. 195, FR 
69904 on Friday, October 7, 2016.
    Affected Public: Individuals or households.

                          Estimate of the Hour Burden for the Collection of Information
                                                   Applicants
----------------------------------------------------------------------------------------------------------------
                               Number of   x Number of             x Number of    Equals               Number of
          VA Forms            respondents   responses     Equals     minutes    (minutes)  / by 60 =     hours
----------------------------------------------------------------------------------------------------------------
10-0491g--Application.......        1,500            1      1,500           60     90,000  .........       1,500
10-0491--Academic                   1,500            1      1,500           60     90,000  .........       1,500
 Verification...............
10-0491e--Evaluations &             1,500            2      3,000           50    150,000  .........       2,500
 Recommendations (2)........
10-0491a--Addendum to           450 (30%)            1        450           10      4,500  .........          75
 Application................
                             -----------------------------------------------------------------------------------
    Total...................  ...........  ...........  .........  ...........  .........  .........       5,575
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[[Page 89577]]


                                  Applicants Selected To Receive a Scholarship
----------------------------------------------------------------------------------------------------------------
                               Number of   x Number of             x Number of    Equals               Number of
          VA Forms            respondents   responses     Equals     minutes    (minutes)  / by 60 =     hours
----------------------------------------------------------------------------------------------------------------
10-0491L--Agreement for the            30            1         30           15        450  .........           8
 VIOMPSP....................
10-0491k--VA Scholarship               30            1         30           10        300  .........           5
 Offer Response.............
10-0491i--Notice of Change             30            1         30           20        600  .........          10
 and/or Annual Academic
 Status Report..............
10-0491h--Notice of                    30            1         30           10        300  .........           5
 Approaching Graduation.....
10-0491d--Education Program            30            1         30           20        600  .........          10
 Completion Notice/Service
 Obligation Placement.......
10-0491j--Request for                   6            1          6           10         60  .........           1
 Deferment for Advanced
 Education..................
10-0491c--Annual VA                    30            1         24           10        240  .........           4
 Employment/Deferment
 Verification...............
                             -----------------------------------------------------------------------------------
    Total...................  ...........  ...........  .........  ...........  .........  .........          43
                             -----------------------------------------------------------------------------------
        Grand Total for       ...........  ...........  .........  ...........  .........  .........       5,618
         VIOMPSP............
----------------------------------------------------------------------------------------------------------------


                                 Health Professional Scholarship Program (HPSP)
                                                   Applicants
----------------------------------------------------------------------------------------------------------------
                               Number of   x Number of             x Number of    Equals               Number of
          VA Forms            respondents   responses     Equals     minutes    (minutes)  / by 60 =     hours
----------------------------------------------------------------------------------------------------------------
10-0491g--Application.......        5,000            1      5,000           60    300,000  .........       5,000
10-0491--Academic                   5,000            1      5,000           60    300,000  .........       5,000
 Verification...............
10-0491e--Evaluations &             5,000            2     10,000           50    500,000  .........       8,333
 Recommendations (2)........
10-0491a--Addendum to          1500 (30%)            1       1500           10     15,000  .........         250
 Application................
                             -----------------------------------------------------------------------------------
    Total...................  ...........  ...........  .........  ...........  .........  .........      18,583
----------------------------------------------------------------------------------------------------------------


                                  Applicants Selected To Receive a Scholarship
----------------------------------------------------------------------------------------------------------------
                               Numnrt of   x Number of             x Number of    Equals               Number of
          VA Forms            respondents   responses     Equals     minutes    (minutes)  / by 60 =     hours
----------------------------------------------------------------------------------------------------------------
10-0491f--Agreement for the           100            1        100           15      1,500  .........          25
 HPSP.......................
10-0491k--VA Scholarship              100            1        100           10      1,000  .........          17
 Offer Response.............
10-0491i--Notice of Change            100            1        100           20      2,000  .........          33
 and/or Annual Academic
 Status Report..............
10-0491h--Notice of                   100            1        100           10      1,000  .........          17
 Approaching Graduation.....
10-0491d--Education Program           100            1        100           20      2,000  .........          33
 Completion Notice/Service
 Obligation Placement.......
10-0491j--Request for                  20            1         20           10        200  .........           3
 Deferment for Advanced
 Education..................
10-0491c--Annual VA                    80            1         80           10        800  .........          13
 Employment/Deferment
 Verification...............
                             -----------------------------------------------------------------------------------
    Total...................  ...........  ...........  .........  ...........  .........  .........         141
                             -----------------------------------------------------------------------------------
        Grand Total for HPSP  ...........  ...........  .........  ...........  .........  .........      18,724
                             -----------------------------------------------------------------------------------
            Grand Total for   ...........  ...........  .........  ...........  .........  .........      24,342
             Both VIOMPSP
             and HPSP.......
----------------------------------------------------------------------------------------------------------------

    Frequency of Response: Annually.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
 Program Specialist, Office of Privacy and Records Management, 
Department of Veterans Affairs.
[FR Doc. 2016-29667 Filed 12-9-16; 8:45 am]
 BILLING CODE 8320-01-P