Federal Register / Vol. 74, No. 173 / Wednesday, September 9, 2009 / Notices 46483 

ADDRESSES: Submit written comments 

on the collection of information through 

the Federal Docket Management System 

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

or to Nancy J. Kessinger, Veterans 

Benefits Administration (20M35), 

Department of Veterans Affairs, 810 

Vermont Avenue, NW., Washington, DC 

20420 or e-mail to 

nancy.kessinger@va.gov. Please refer to 

‘‘OMB Control No. 2900–0358’’ in any 

correspondence. During the comment 

period, comments may be viewed online 

through FDMS. 

FOR FURTHER INFORMATION CONTACT: 

Nancy J. Kessinger at (202) 461–9769 or 

FAX (202) 275–5947. 

SUPPLEMENTARY INFORMATION: Under the 

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

3501—3521), 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, VBA invites 

comments on: (1) Whether the proposed 

collection of information is necessary 

for the proper performance of VBA’s 

functions, including whether the 

information will have practical utility; 

(2) the accuracy of VBA’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. 

Title: Supplemental Information for 

Change of Program or Reenrollment 

after Unsatisfactory Attendance, 

Conduct or Progress, VA Form 22–8873. 

OMB Control Number: 2900–0358. 

Type of Review: Extension of a 

currently approved collection. 

Abstract: Veterans and other eligible 

persons may change their program of 

education under conditions prescribed 

by Title 38 U.S.C. 3691. A claimant can 

normally make one change of program 

without VA approval. VA approval is 

required if the claimant makes any 

additional change of program. Before 

VA can approve benefits for a second or 

subsequent change of program, VA must 

first determine that the new program is 

suitable to the claimant’s aptitudes, 

interests, and abilities, or that the cause 

of any unsatisfactory progress or 

conduct has been resolved before 

entering into a different program. VA 

Form 22–8873 is used to gather the 

necessary information only if the 

suitability of the proposed training 

program cannot be established from 

information already available in the 

claimant’s VA education records or the 

results of academic or vocational 

counseling are not available to VA. 

Affected Public: Individuals or 

households. 

Estimated Annual Burden: 14,629 

hours. 

Estimated Average Burden per 

Respondent: 30 minutes. 

Frequency of Response: On occasion. 

Estimated Number of Respondents: 

29,258. 

Dated: September 2, 2009. 

By direction of the Secretary. 

Denise McLamb, 

Program Analyst, Enterprise Records Service. 

[FR Doc. E9–21571 Filed 9–8–09; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

[OMB Control No. 2900–0017] 

Agency Information Collection 

(Annual-Final Report and Account) 

Activities 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. 

DATES: Comments must be submitted on 

or before October 9, 2009. 

ADDRESSES: Submit written comments 

on the collection of information through 

http://www.Regulations.gov or to VA’s 

OMB Desk Officer, Office of Information 

and Regulatory Affairs, New Executive 

Office Building, Room 10235, 

Washington, DC 20503, (202) 395–7316. 

Please refer to ‘‘OMB Control No. 2900– 

0017’’ 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. 2900–0017.’’ 

SUPPLEMENTARY INFORMATION: 

Titles: 

a. Annual-Final Report and Account, 

VA Form 21–4706. 

b. Federal Fiduciary’s Account, VA 

Form 21–4706b. 

c. Court Appointed Fiduciary’s 

Account, VA Form 21–4706c. 

d. Account Book, VA Form 21–4718. 

e. Certificate of Balance on Deposit 

and Authorization To Disclose Financial 

Records (Pursuant to Title 38, U.S.C., 

Chapter 55 and Title 12, U.S.C., Chapter 

35), VA Form 21–4718a. 

OMB Control Number: 2900–0017. 

Type of Review: Extension of a 

currently approved collection. 

Abstract: VA maintains supervision of 

the distribution and use of VA benefits 

paid to fiduciaries on behalf of VA 

claimants who are incompetent, a 

minor, or under legal disability. The 

forms are used to verify beneficiaries’ 

deposit remaining at a financial 

institution against a fiduciary’s 

accounting. The following forms will be 

used to ensure claimants’ benefits 

payments are administered properly. 

a. VA Forms 21–4706, 4706b and 

4706c are used by estate to determine 

proper usage of benefits paid to 

fiduciaries. The 21–4706 and 21–4706b 

are both necessary to conform to 

requirement of various state courts. 

b. VA Form 21–4718 is provided to 

VA fiduciaries to submit accountings to 

either State courts or the VA. It is not 

a reporting form per se but a vehicle to 

assist the fiduciary in accurately 

maintaining records of monies received 

and spent. 

c. VA Form 21–4718a—Fiduciaries 

are required to obtain certifications that 

the balances remaining on deposit in 

financial institutions as shown on 

accountings are correct. Certifying 

official at a financial institution 

completing the form must affix the 

institution’s official seal or stamp. The 

data collected is used to appoint an 

appropriate fiduciary for a VA 

beneficiary and to prevent fiduciaries 

from supplying false certification, 

embezzling funds, and possibly prevent 

and/or identify fraud, waste and abuse 

of government funds paid to fiduciaries 

on behalf of VA beneficiaries. 

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 29, 2009, at pages 31111–31112. 


cprice-sewell on DSK2BSOYB1PROD with NOTICES
46484 Federal Register / Vol. 74, No. 173 / Wednesday, September 9, 2009 / Notices 

Affected Public: Individuals or 

households. 

Estimated Annual Burden: 

a. Annual-Final Report and Account, 

VA Form 21–4706—1,100. 

b. Federal Fiduciary’s Account, VA 

Form 21–4706b—6,300. 

c. Court Appointed Fiduciary’s 

Account, VA Form 21–4706c—2,000. 

d. Account Book, VA Form 21–4718— 

20,000. 

e. Certificate of Balance on Deposit 

and Authorization To Disclose Financial 

Records, VA Form 21–4718a–166. 

Estimated Average Burden per 

Respondent: 

a. Annual-Final Report and Account, 

VA Form 21–4706—30 minutes. 

b. Federal Fiduciary’s Accounts, VA 

Form 21–4706b—27 minutes. 

c. Court Appointed Fiduciary’s 

Account, VA Form 21–4706c—30 

minutes. 

d. Account Book, VA Form 21–4718– 

21⁄2 hours. 

e. Certificate of Balance on Deposit 

and Authorization To Disclose Financial 

Records, VA Form 21–4718a–3 minutes. 

Frequency of Response: Annually. 

Estimated Number of Respondents: 

a. Annual-Final Report and Account, 

VA Form 21–4706–2,200. 

b. Federal Fiduciary’s Accounts, VA 

Form 21–4706b–14,000. 

c. Court Appointed Fiduciary’s 

Account, VA Form 21–4706c–4,000. 

d. Account Book, VA Form 21–4718– 

8,000. 

e. Certificate of Balance on Deposit 

and Authorization To Disclose Financial 

Records, VA Form 21–4718a–3,312. 

Dated: September 2, 2009. 

By direction of the Secretary. 

Denise McLamb, 

Program Analyst, Enterprise Records Service. 

[FR Doc. E9–21572 Filed 9–8–09; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

[OMB Control No. 2900–0427] 

Agency Information Collection (Former 

POW Medical History), VA Form 10– 

0048 Activities 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. 

DATES: Comments must be submitted on 

or before October 9, 2009. 

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– 

0427’’ 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@mail.va.gov. Please 

refer to ‘‘OMB Control No. 2900–0427.’’ 

SUPPLEMENTARY INFORMATION: 

Titles: Former POW Medical History, 

VA Form 10–0048. 

OMB Control Number: 2900–0427. 

Type of Review: Revision of a 

currently approved collection. 

Abstract: VA Form 10–0048 is 

completed by a VA physician during a 

medical examination of a Former 

Prisoner of War veteran. VA will use the 

data collected as a guide and reference 

for treatment planning for the FPOW 

veteran. 

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 

29, 2009, at pages 31110–31111. 

Affected Public: Individuals or 

households. 

Estimated Total Annual Burden: 113 

hours. 

Estimated Average Burden per 

Respondent: 90 minutes. 

Frequency of Response: One time. 

Estimated Number of Respondents: 

75. 

Dated: September 2, 2009. 

By direction of the Secretary. 

Denise McLamb, 

Program Analyst, Enterprise Records Service. 

[FR Doc. E9–21573 Filed 9–8–09; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

[OMB Control No. 2900–0260] 

Proposed Information Collection 

(Request for and Authorization To 

Release Medical Records or Health 

Information) Activity: Comment 

Request 

AGENCY: Veterans Health 

Administration, Department of Veterans 

Affairs. 

ACTION: Notice. 

SUMMARY: The Veterans Health 

Administration (VHA) 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 

revision of a currently approved 

collection, and allow 60 days for public 

comment in response to the notice. This 

notice solicits comments on information 

needed to obtain a patient written 

consent to disclose medical records or 

health information to individuals or 

third parties. 

DATES: Written comments and 

recommendations on the proposed 

collection of information should be 

received on or before November 9, 2009. 

ADDRESSES: Submit written comments 

on the collection of information through 

Federal Docket Management System 

(FDMS) at 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. 2900–0260’’ in any 

correspondence. During the comment 

period, comments may be viewed online 

through FDMS. 

FOR FURTHER INFORMATION CONTACT: 

Mary Stout, (202) 461–5867 or FAX 

(202) 273–9381. 

SUPPLEMENTARY INFORMATION: Under the 

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

3501–3521), 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 


cprice-sewell on DSK2BSOYB1PROD with NOTICES