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###### Department of Veterans Affairs

          - [OMB Control No. 2900-0095]

# AGENCY:

Veterans Benefits Administration, Department of Veterans Affairs.

# ACTION:

Notice.

# SUMMARY:

In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice announces that the Veterans Benefits Administration (VBA), Department of Veterans Affairs, has submitted 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 December 2, 2004.

# FOR FURTHER INFORMATION CONTACT:

                        Denise McLamb, Records Management Service (005E3), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 273-8030, fax (202) 273-5981 or e-mail                         *denise.mclamb@mail.va.gov.*                         Please refer to “OMB Control No. 2900-0095.” Send comments and recommendations concerning any aspect of the information collection to VA's OMB Desk Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC 20503, (202) 395-7316. Please refer to “OMB Control No. 2900-0095” in any correspondence.                    

# SUPPLEMENTARY INFORMATION:

*Title:*                     Pension Claim Questionnaire for Farm Income, VA Form 21-4165.                

*OMB Control Number:*                     2900-0095.                

*Type of Review:*                     Extension of a currently approved collection.                

*Abstract:*                     VA Form 21-4165 is used to gather information necessary to determine a claimant's countable annual income and available assets due to farm operations. Eligibility to income-based benefits cannot be determined without complete information about a claimant's income. Farm income is not necessarily received on a weekly or monthly basis, and farm operating expenses must be considered in determining income and total assets. If eligibility exists, the information will be used to determine the proper rate of benefits.                

                    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 on June 15, 2004, at page 33466.                

*Affected Public:*                     Individuals or households and farms.                

*Estimated Annual Burden:*                     1,038 hours.                

*Estimated Average Burden per Respondent:*                     30 minutes.                

*Frequency of Response:*                     Annually.                

*Estimated Number of Respondents:*                     2,075.                

Dated: October 19, 2004.

By direction of the Secretary.

Loise Russell,

Director, Records Management Service.

[FR Doc. 04-24399 Filed 11-1-04; 8:45 am]

BILLING CODE 8320-01-P