[Federal Register Volume 86, Number 96 (Thursday, May 20, 2021)]
[Notices]
[Pages 27502-27503]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-10638]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0858]


Agency Information Collection Activity Under OMB Review: 
Authorization and Consent To Release Information to the Department of 
Veterans Affairs (VA), and General Release for Medical Provider 
Information to the Department of Veterans Affairs (VA)

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 (VBA), 
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: Written comments and recommendations for the proposed 
information collection should be sent within 30 days of publication of 
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular 
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function. Refer to 
``OMB Control No. 2900-0858''.

FOR FURTHER INFORMATION CONTACT: Maribel Aponte, Office of Enterprise 
and Integration, Data Governance Analytics (008), 1717 H Street NW, 
Washington, DC 20006, (202) 266-4688 or email [email protected]. 
Please refer to ``OMB Control No. 2900-0858'' in any correspondence.

SUPPLEMENTARY INFORMATION: 

[[Page 27503]]

    Authority: 38 U.S.C. 5101(a)(1).
    Title: Authorization and Consent to Release Information to the 
Department of Veterans Affairs (VA) (VA Form 21-4142), and General 
Release for Medical Provider Information to the Department of Veterans 
Affairs (VA) (VA Form 21-4142a).
    OMB Control Number: 2900-0858.
    Type of Review: Reinstatement of a previously approved collection.
    Abstract: VA Form 21-4142 is used to authorize the disclosure of 
information to the VA and VA Form 21-4142a is used to gather the 
necessary information to request medical provider information to the 
VA. Without the information solicited by these forms, VA would be 
unable to determine eligibility, and benefits would not be properly 
paid.
    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 86 FR 50 on March 17, 2021, page 14687.
    Affected Public: Individuals or Households.
    Estimated Annual Burden: 10,616.
    Estimated Average Burden per Respondent: 5 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents: 127,397.

    By direction of the Secretary.
Maribel Aponte,
VA PRA Clearance Officer, Office of Enterprise and Integration, Data 
Governance Analytics, Department of Veterans Affairs.
[FR Doc. 2021-10638 Filed 5-19-21; 8:45 am]
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