9276 Federal Register / Vol. 75, No. 39 / Monday, March 1, 2010 / Notices 

and analyzed in connection with NMTC 

evaluation efforts. 

Current Actions: Extension of a 

currently approved collection. 

Type of review: Regular review. 

Affected Public: Business or other forprofit institutions, not-for-profit 

institutions, and State, local and Tribal 

entities. 

Estimated Number of Respondents: 

495. 

Estimated Annual Time per 

Respondent: 12 hours. 

Estimated Total Annual Burden 

Hours: 5,940 hours. 

Requests for Comments: Comments 

submitted in response to this notice will 

be summarized and/or included in the 

request for OMB approval. All 

comments will become a matter of 

public record. The specific section of 

the allocation agreement for which 

comments are sought is the reporting 

requirement that allocatees provide 

notice to the CDFI Fund, through the 

CDFI Fund’s allocation tracking system, 

of the receipt of a Qualified Equity 

Investment. Comments are invited on: 

(a) Whether the collection of 

information is necessary for the proper 

performance of the functions of the 

agency, including whether the 

information shall have practical utility; 

(b) the accuracy of the agency’s estimate 

of the burden of the collection of 

information; (c) ways to enhance the 

quality, utility, and clarity of the 

information to be collected; (d) ways to 

minimize the burden of the collection of 

information on respondents, including 

through the use of technology; and (e) 

estimates of capital or start-up costs and 

costs of operation, maintenance, and 

purchase of services required to provide 

information. 

Authority: 12 U.S.C. 4701 et seq.; 26 U.S.C. 

45D. 

Dated: February 19, 2010. 

Jeffrey C. Berg, 

Legal Counsel, Community Development 

Financial Institutions Fund. 

[FR Doc. 2010–3900 Filed 2–26–10; 8:45 am] 

BILLING CODE 4810–70–M 

DEPARTMENT OF THE TREASURY 

Office of Thrift Supervision 

[AC–35: OTS No. H–4649] 

Harvard Illinois Bancorp, Inc., Harvard, 

Illinois; Approval of Conversion 

Application 

Notice is hereby given that on 

February 12, 2010, the Office of Thrift 

Supervision approved the application of 

Harvard Savings Bank, Harvard, Illinois, 

to convert to the stock form of 

organization. Copies of the application 

are available for inspection by 

appointment (phone number: 202–906– 

5922 or e-mail Public.Info@

OTS.Treaas.gov) at the Public Reading 

Room, 1700 G Street, NW., Washington, 

DC 20552, and the OTS Central Regional 

Office, 1 South Wacker Drive, Suite 

2000, Chicago, Illinois 60606. 

Dated: February 19, 2010. 

By the Office of Thrift Supervision. 

Sandra E. Evans, 

Federal Register Liaison. 

[FR Doc. 2010–3897 Filed 2–26–10; 8:45 am] 

BILLING CODE 6720–01–M 

DEPARTMENT OF VETERANS 

AFFAIRS 

[OMB Control No. 2900–0219] 

Proposed Information Collection 

(Application for CHAMPVA Benefits); 

Comment Request 

AGENCY: Veterans Health 

Administration, Department of Veterans 

Affairs. 

ACTION: Notice. 

SUMMARY: The Veterans Health 

Administration (VHA), Department of 

Veterans Affairs (VA), is announcing an 

opportunity for public comment on the 

proposed collection of certain 

information by the agency. Under the 

Paperwork Reduction Act (PRA) of 

1995, Federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information, including each proposed 

extension of a currently approved 

collection, and allow 60 days for public 

comment in response to the notice. This 

notice solicits comments for information 

needed to determine eligibility of 

persons applying for healthcare benefits 

under Civilian Health and Medical 

Program—VA and to request 

preauthorization of certain health care 

services and benefits for children of 

Vietnam veterans born with spina bifida 

and certain other covered birth defects. 

DATES: Written comments and 

recommendations on the proposed 

collection of information should be 

received on or before April 30, 2010. 

ADDRESSES: Submit written comments 

on the collection of information through 

the Federal Docket Management System 

(FDMS) at http://www.Regulations.gov; 

or to Mary Stout, Veterans Health 

Administration (193E1), Department of 

Veterans Affairs, 810 Vermont Avenue, 

NW., Washington, DC 20420 or e-mail: 

mary.stout@va.gov. Please refer to ‘‘OMB 

Control No. 2900–0219’’ in any 

correspondence. During the comment 

period, comments may be viewed online 

through FDMS. 

FOR FURTHER INFORMATION CONTACT: 

Mary Stout at (202) 461–5867 or FAX 

(202) 273–9381. 

SUPPLEMENTARY INFORMATION: Under the 

PRA of 1995 (Pub. L. 104–13; 44 U.S.C. 

3501–21), Federal agencies must obtain 

approval from the Office of Management 

and Budget (OMB) for each collection of 

information they conduct or sponsor. 

This request for comment is being made 

pursuant to Section 3506(c)(2)(A) of the 

PRA. 

With respect to the following 

collection of information, VHA invites 

comments on: (1) Whether the proposed 

collection of information is necessary 

for the proper performance of VHA’s 

functions, including whether the 

information will have practical utility; 

(2) the accuracy of VHA’s estimate of 

the burden of the proposed collection of 

information; (3) ways to enhance the 

quality, utility, and clarity of the 

information to be collected; and (4) 

ways to minimize the burden of the 

collection of information on 

respondents, including through the use 

of automated collection techniques or 

the use of other forms of information 

technology. 

Titles: 

a. Application for CHAMPVA 

Benefits, VA Form 10–10d. 

b. CHAMPVA Claim Form, VA Form 

10–7959a. 

c. CHAMPVA Other Health Insurance 

(OHI) Certification, VA Form 10–7959c. 

d. CHAMPVA Potential Liability 

Claim, VA Form 10–7959d. 

e. Claim for Miscellaneous Expenses, 

VA Form 10–7959e 

OMB Control Number: 2900–0219. 

Type of Review: Extension of a 

currently approved collection. 

Abstracts: 

a. VA Form 10–10d is used to 

determine eligibility of persons 

applying for healthcare benefits under 

the CHAMPVA program. 

b. VA Form 10–7959a is used to 

accurately adjudicate and process 

beneficiaries claims for payment/ 

reimbursement of related healthcare 

expenses. 

c. VA Form 10–7959c is used to 

systematically obtain other health 

insurance information and to correctly 

coordinate benefits among all liable 

parties. 

d. VA Form 10–7959d is used to 

gather additional information relative to 

the injury or illness as well as third 

party claim information. 

e. Beneficiaries complete VA Form 

10–7959e to claim payment/ 

mstockstill on DSKH9S0YB1PROD with NOTICES