76080 Federal Register / Vol. 75, No. 234 / Tuesday, December 7, 2010 / Notices 

send a facsimile transmission to (202) 

906–7755. 

FOR FURTHER INFORMATION CONTACT: For 

further information or to obtain a copy 

of the submission to OMB, please 

contact Ira L. Mills at, 

ira.mills@ots.treas.gov, or on (202) 906– 

6531, or facsimile number (202) 906– 

6518, Regulations and Legislation 

Division, Chief Counsel’s Office, Office 

of Thrift Supervision, 1700 G Street, 

NW., Washington, DC 20552. 

SUPPLEMENTARY INFORMATION: OTS may 

not conduct or sponsor an information 

collection, and respondents are not 

required to respond to an information 

collection, unless the information 

collection displays a currently valid 

OMB control number. As part of the 

approval process, we invite comments 

on the following information collection. 

Title of Proposal: Purchase of Branch 

Office(s) and/or Transfer of Assets/ 

Liabilities. 

OMB Number: 1550–0025. 

Form Number: N/A. 

Description: The information for a 

Purchase of Branch Office(s) and/or 

Transfer of Assets/Liabilities 

application is to provide the OTS with 

the information necessary to determine 

if the request should be approved. It 

allows for OTS evaluation of 

supervisory, accounting, and legal 

issues related to these transaction types. 

If the information were not collected, 

OTS would not be able to properly 

evaluate whether the proposed 

transaction meets applicable criteria. 

Type of Review: Extension of a 

currently approved collection. 

Affected Public: Business or other forprofit. 

Estimated Number of Respondents: 

40. 

Estimated Frequency of Response: On 

occasion. 

Estimated Total Burden: 960 hours. 

Clearance Officer: Ira L. Mills, (202) 

906–6531, Office of Thrift Supervision, 

1700 G Street, NW., Washington, DC 

20552. 

Dated: December 1, 2010. 

Ira L. Mills, 

Paperwork Clearance Officer, Office of Chief 

Counsel, Office of Thrift Supervision. 

[FR Doc. 2010–30676 Filed 12–6–10; 8:45 am] 

BILLING CODE 6720–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

[OMB Control No. 2900–0675] 

Agency Information Collection (VetBiz 

Vendor Information Pages Verification 

Program) Activity Under OMB Review 

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. 3501–21), this notice 

announces that the Veterans Office of 

Small and Disadvantaged Business 

Utilization (OSDBU), 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; it includes 

the actual data collection instrument. 

DATE: Comments must be submitted on 

or before January 6, 2011. 

ADDRESSES: Submit written comments 

on the collection of information through 

http://www.Regulations.gov; or 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– 

0675’’ in any correspondence. 

FOR FURTHER INFORMATION CONTACT: 

Denise McLamb, Enterprise Records 

Service (005R1B), Department of 

Veterans Affairs, 810 Vermont Avenue, 

NW., Washington, DC 20420, (202) 461– 

7485, FAX (202) 565–7870 or e-mail: 

denise.mclamb@va.gov. Please refer to 

‘‘OMB Control No. 2900–0675.’’ 

SUPPLEMENTAL INFORMATION: 

Title: VetBiz Vendor Information 

Pages Verification Program, VA Form 

0877. 

OMB Control Number: 2900–0675. 

Type of Review: Extension of a 

currently approved collection. 

Abstract: The Vendor Information 

Pages (VIP) will be used to assist federal 

agencies in identifying small businesses 

owned and controlled by veterans and 

service-connected disabled veterans. 

This information is necessary to ensure 

that veteran own businesses are given 

the opportunity to participate in Federal 

contracts and receive contract 

solicitations information automatically. 

VA will use the data collected on VA 

Form 0877 to verify small businesses as 

veteran-owned or service-disabled 

veteran-owned. 

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 

September 29, 2010, at page 60169. 

Affected Public: Business or other forprofit. 

Estimated Annual Burden: 10,000 

hours. 

Estimated Average Burden per 

Respondent: 30 minutes. 

Frequency of Response: On occasion. 

Estimated Number of Respondents: 

20,000. 

Dated: December 1, 2010. 

By direction of the Secretary. 

Denise McLamb, 

Program Analyst, Enterprise Records Service. 

[FR Doc. 2010–30550 Filed 12–6–10; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

[OMB Control No. 2900–0080] 

Agency Information Collection (Claim 

for Payment of Cost of Unauthorized 

Medical Services) Activity Under OMB 

Review 

AGENCY: Veterans Health 

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 Health 

Administration (VHA), 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 

includes the actual data collection 

instrument. 

DATE: Comments must be submitted on 

or before January 6, 2011. 

ADDRESSES: Submit written comments 

on the collection of information through 

http://www.Regulations.gov or 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– 

0080’’ in any correspondence. 

FOR FURTHER INFORMATION CONTACT: 

Denise McLamb, Enterprise Records 

Service (005R1B), Department of 

Veterans Affairs, 810 Vermont Avenue, 


emcdonald on DSK2BSOYB1PROD with NOTICES
Federal Register / Vol. 75, No. 234 / Tuesday, December 7, 2010 / Notices 76081 

NW., Washington, DC 20420, (202) 461– 

7485, fax (202) 273–0443 or e-mail 

denise.mclamb@va.gov. Please refer to 

‘‘OMB Control No. 2900–0080.’’ 

SUPPLEMENTAL INFORMATION: 

Titles: 

a. Claim for Payment of Cost of 

Unauthorized Medical Services, VA 

Form 10–583. 

b. Funeral Arrangements Form for 

Disposition of Remains of the Deceased, 

VA Form 10–2065. 

c. Authority and Invoice for Travel by 

Ambulance or Other Hired Vehicle, VA 

Form 10–2511. 

d. Authorization and Invoice for 

Medical and Hospital Services, VA 

Form 10–7078. 

e. Request for Payment of Beneficiary 

Travel after the Date of Service. 

OMB Control Number: 2900–0080. 

Type of Review: Revision of a 

currently approved collection. 

Abstract: 

a. VA Form 10–583 is used to request 

payment or reimbursement of the cost of 

unauthorized non-VA medical services. 

b. VA Form 10–2065 is completed by 

VA personnel during an interview with 

relatives of the deceased, and to identify 

the funeral home to which the remains 

are to be released. The form is also used 

as a control document when VA is 

requested to arrange for the 

transportation of the deceased from the 

place of death to the place of burial, 

and/or when burial is requested in a 

National Cemetery. 

c. VA Form 10–2511 is used to 

process payment for ambulance or other 

hired vehicular forms of transportation 

for eligible veterans to and from VA 

health care facilities for examination, 

treatment or care. 

d. VA uses VA Form 10–7078 to 

authorize expenditures from the 

medical care account and process 

payment of medical and hospital 

services provided by other than Federal 

health providers to VA beneficiaries. 

e. Claimants who request payment for 

beneficiary travel after the time of 

service may do so in writing or in 

person. 

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 

September 29, 2010, at page 60170. 

Affected Public: Business or other for 

profit. 

Estimated Total Annual Burden: 

a. VA Form 10–583—17,188. 

b. VA Form 10–2065—2,053. 

c. VA Form 10–2511—2,333. 

d. VA Form 10–7078—8,400. 

e. Request for Payment of Beneficiary 

Travel after the Date of Service—417. 

Estimated Average Burden Per 

Respondent: 

a. VA Form 10–583—15 minutes. 

b. VA Form 10–2065—5 minutes. 

c. VA Form 10–2511—2 minutes 

d. VA Form 10–7078—2 minutes. 

e. Request for Payment of Beneficiary 

Travel after the Date of Service—1 

minute. 

Frequency of Response: Annually. 

Estimated Number of Respondents: 

a. VA Form 10–583—68,750 

respondents. 

b. VA Form 10–2065—24,630 

respondents. 

c. VA Form 10–2511—70,000 

respondents. 

d. VA Form 10–7078—252,000 

respondents. 

e. Request for Payment of Beneficiary 

Travel after the Date of Service—25,000. 

Dated: December 1, 2010. 

By direction of the Secretary. 

Denise McLamb, 

Program Analyst, Enterprise Records Service. 

[FR Doc. 2010–30551 Filed 12–6–10; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

[OMB Control No. 2900–0749] 

Agency Information Collection 

(Disability Benefits Questionnaires) 

Activity Under OMB Review 

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, 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; it includes 

the actual data collection instrument. 

DATE: Comments must be submitted on 

or before January 6, 2011. 

ADDRESSES: Submit written comments 

on the collection of information through 

http://www.Regulations.gov or 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– 

0749’’ in any correspondence. 

FOR FURTHER INFORMATION CONTACT: 

Denise McLamb, Enterprise Records 

Service (005R1B), Department of 

Veterans Affairs, 810 Vermont Avenue, 

NW., Washington, DC 20420, (202) 461– 

7485, FAX (202) 273–0443 or e-mail 

denise.mclamb@va.gov. Please refer to 

‘‘OMB Control No. 2900–0749.’’ 

SUPPLEMENTAL INFORMATION: 

Titles: 

a. Ischemic Heart Disease (IHD) 

Disability Benefits Questionnaire, VA 

Form 21–0960a–1. 

b. Hairy Cell and Other B-Cell 

Leukemias Disability Benefits 

Questionnaire, VA Form 21–0960b–1. 

c. Parkinson’s Disease Disability 

Benefits Questionnaire, VA Form 21– 

0960c–1. 

OMB Control Number: 2900–0749. 

Type of Review: Extension of a 

currently approved collection. 

Abstract: VA Forms 21–0960a–1, 21– 

0960b–1, and 21–0960b–1 are used to 

expedite claims for the following 

presumptive diseases based on 

herbicide exposure: Hairy Cell and 

Other Chronic B-cell Leukemias, 

Parkinson’s and Ischemic Heart 

diseases. Veterans have the option of 

providing the forms to their private 

physician for completion and 

submission to VA in lieu of scheduling 

a VA medical examination. The data 

collected will be used to adjudicate 

veterans claim for disability 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 

September 29, 2010, at pages 60170– 

60171. 

Affected Public: Individuals or 

households. 

Estimated Annual Burden: 

a. Ischemic Heart Disease (IHD) 

Disability Benefits Questionnaire, VA 

Form 21–0960a–1—13,750. 

b. Hairy Cell and Other B-Cell 

Leukemias Disability Benefits 

Questionnaire, VA Form 21–0960b–1— 

500. 

c. Parkinson’s Disease Disability 

Benefits Questionnaire, VA Form 21– 

0960c–1—1,250. 

Estimated Average Burden per 

Respondent: 15 minutes. 

Frequency of Response: On occasion. 

Estimated Number of Respondents: 

a. Ischemic Heart Disease (IHD) 

Disability Benefits Questionnaire, VA 

Form 21–0960a–1—55,000. 


emcdonald on DSK2BSOYB1PROD with NOTICES