[Federal Register Volume 82, Number 84 (Wednesday, May 3, 2017)]
[Notices]
[Page 20686]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-08932]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0065]


Agency Information Collection Activity Under OMB Review: Request 
for Employment Information in Connection With Claim for Disability 
Benefits

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, 
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 and it 
includes the actual data collection instrument.

DATES: Comments must be submitted on or before June 2, 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-
0065'' 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-
0065'' in any correspondence.

SUPPLEMENTARY INFORMATION: 
    Authority: 44 U.S.C. 3501-21.
    Title: (Request for Employment Information in Connection with Claim 
for Disability Benefits (VA Form 21-4192)).
    OMB Control Number: 2900-0065.
    Type of Review: Revision of a currently approved collection.
    Abstract: VA Form 21-4192 is used to gather necessary employment 
information from veterans' employers so VA can determine eligibility to 
increased disability benefits based on unemployability.
    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 at Volume 82 FR 12 on January 19, 2017, page 
6729.
    Affected Public: Individuals or Households.
    Estimated Annual Burden: 15,000 hours.
    Estimated Average Burden per Respondent: 15 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents: 60,000.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Enterprise Records Service, Office of 
Quality and Compliance, Department of Veterans Affairs.
[FR Doc. 2017-08932 Filed 5-2-17; 8:45 am]
 BILLING CODE 8320-01-P