[Federal Register Volume 82, Number 132 (Wednesday, July 12, 2017)]
[Notices]
[Pages 32225-32226]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-14561]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0075]


Agency Information Collection Activity Under OMB Review: 
Statement in Support of Claim

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 August 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-
0075'' 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-
0075'' in any correspondence.

SUPPLEMENTARY INFORMATION: 
    Authority: 44 U.S.C. 3501-21.
    Title: Statement in Support of Claim (VA Form 21-4138).
    OMB Control Number: 2900-0075.
    Type of Review: Revision of a currently approved collection.
    Abstract: VA Form 21-4138 is used by claimants to provide self-
certified statements in support of various types of claims processed by 
the agency. VA compensation and pension programs

[[Page 32226]]

require that statements submitted by or on behalf of a claimant contain 
certification by the respondent that the information provided is true 
and correct. This form is designed to facilitate claims processing by 
providing a uniform format for the certification statement.
    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 84 on May 3, 2017, page 20687.
    Affected Public: Individuals or Households.
    Estimated Annual Burden: 188,000.
    Estimated Average Burden per Respondent: 15 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents: 752,000.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Office of Privacy and Records Management, 
Department of Veterans Affairs.
[FR Doc. 2017-14561 Filed 7-11-17; 8:45 am]
BILLING CODE 8320-01-P