[Federal Register Volume 82, Number 109 (Thursday, June 8, 2017)]
[Notices]
[Page 26737]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-11886]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0079]


Agency Information Collection Activity Under OMB Review: 
Employment Questionnaire

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 July 10, 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-
0079'' 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-
0079'' in any correspondence.

SUPPLEMENTARY INFORMATION:

    Authority: 44 U.S.C. 3501-21.

    Title: Employment Questionnaire (VA Form 21-4140 & 21-4140-1).
    OMB Control Number: 2900-0079.
    Type of Review: Revision of a currently approved collection.
    Abstract: VA Forms 21-4140 and 21-4140-1 are to be used to gather 
the necessary information to determine continued entitlement to 
individual unemployability for veterans who are unable to secure or 
follow a substantially gainful occupation as a result of his or her 
service-connected disabilities.
    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 82 FR 35 on February 23, 2017, page 11498.
    Affected Public: Individuals or Households.
    Estimated Annual Burden: 10,833.
    Estimated Average Burden per Respondent: 5 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents: 130,000.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Office of Privacy and Records Management, 
Department of Veterans Affairs.
[FR Doc. 2017-11886 Filed 6-7-17; 8:45 am]
 BILLING CODE 8320-01-P