Federal Register / Vol. 74, No. 187 / Tuesday, September 29, 2009 / Notices 49917 

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 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 determine a veteran’s 

eligibility, dependency, and income, as 

applicable, for compensation and/or 

pension benefits and to assist veterans 

in reopening a previously denied 

disability compensation claim or to 

request an increase in benefit and/or 

claim for a new service-connected 

condition. 

DATES: Written comments and 

recommendations on the proposed 

collection of information should be 

received on or before November 30, 

2009. 

ADDRESSES: Submit written comments 

on the collection of information through 

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: 

nancy.kessinger@va.gov. Please refer to 

‘‘OMB Control No. 2900–0001’’ in any 

correspondence. During the comment 

period, comments may be viewed online 

through the Federal Docket Management 

System (FDMS) at http:// 

www.Regulations.gov. 

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. 

Titles: 

a. Veteran’s Application for 

Compensation and/or Pension, VA Form 

21–526. 

b. Veteran’s Supplemental Claim 

Application, VA Form 21–526b. 

c. Authorization and Consent Release 

Information to the Department of 

Veterans Affairs (VA), VA Form 21– 

4142. 

OMB Control Number: 2900–0001. 

Type of Review: Revision of a 

currently approved collection. 

Abstracts: 

a. Veterans complete VA Form 21–526 

to apply for compensation and/or 

pension benefits. 

b. Veterans who previously filed a 

claim using VA Form 21–526, 

Application for Compensation or 

Pension, and who wish to request an 

increase in a service connected 

condition, reopen their claim for a 

previously denied claim, and/or file a 

claim for a new service-connected 

condition must complete VA Form 21– 

526b. VA Form 21–526b will be used for 

supplemental claims for disability 

compensation. 

c. Veterans who need VA’s assistance 

in obtaining non-VA medical records 

must complete VA Form 21–4142. 

Affected Public: Individuals or 

households. 

Estimated Annual Burden: 

a. VA Form 21–526—391,708. 

b. VA Form 21–526b—50,000. 

c. VA Form 21–4142—274. 

Estimated Average Burden Per 

Respondent: 

a. VA Form 21–526—1 hour. 

b. VA Form 21–526b—15 minutes 

c. VA Form 21–4142—5 minutes. 

Frequency of Response: On occasion. 

Estimated Number of Respondents: 

a. VA Form 21–526—391,708 

b. VA Form 21–526b—200,000 

c. VA Form 21–4142—3,292. 

Dated: September 24, 2009. 

By direction of the Secretary. 

Denise McLamb, 

Program Analyst, Enterprise Records Service. 

[FR Doc. E9–23481 Filed 9–28–09; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF VETERANS 

AFFAIRS 

[OMB Control No. 2900–0376] 

Proposed Information Collection 

(Agent Orange Registry Code Sheet); 

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 

extension of a currently approved 

collection, and allow 60 days for public 

comment in response to the notice. This 

notice solicits comments on the 

information needed to maintain an upto-date Agent Orange Registry. 

DATES: Written comments and 

recommendations on the proposed 

collection of information should be 

received on or before November 30, 

2009. 

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. 2900–0376’’ 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. 

3501–3521), 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 

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. 

Title: Agent Orange Registry Code 

Sheet, VA Form 10–9009. 


jlentini on DSKJ8SOYB1PROD with NOTICES
49918 Federal Register / Vol. 74, No. 187 / Tuesday, September 29, 2009 / Notices 

OMB Control Number: 2900–0376. 

Type of Review: Extension of a 

currently approved collection. 

Abstract: VA in an on-going effort to 

maintain an Agent Orange Registry 

(AOR) developed a reporting format to 

facilitate the collection of information 

obtained from veterans during the Agent 

Orange registry examination process. 

VA is required to organize and update 

the information contained in AOR to be 

able to notify Vietnam era veterans who 

served in the Republic of Vietnam of 

any increased health risks resulting 

from exposure to dioxin or other toxic 

agents. VA may also provide, upon 

request, a health examination, 

consultation, and counseling veterans 

who are eligible for listing or inclusion 

in any health-related registry 

administrated by VA that is similar to 

the Persian Gulf War Veterans Health 

Registry. Registry examinations is 

provided to veterans who served in 

Korea in 1968 or 1969, and/or any U.S. 

veteran who may have been exposed to 

dioxin, or other toxic substance in a 

herbicide or defoliant, during the 

conduct of, or as a result of, the testing, 

transporting, or spraying of herbicides, 

and who requests an Agent Orange 

Registry examination. VA will enter the 

information obtained from the veteran 

during the interview on VA Form 10– 

9009, Agent Orange Registry Code 

Sheet. The registry will provide a 

mechanism that will catalogue 

prominent symptoms, reproductive 

health, and diagnoses and to 

communicate with Agent Orange 

veterans. VA will inform the veterans on 

research finding or new compensation 

policies through periodic newsletters. 

The registry is not designed or intended 

to be a research tool and therefore the 

results cannot be generalized to 

represent all Agent Orange veterans. 

Affected Public: Individuals or 

Households. 

Estimated Total Annual Burden: 

6,667 hours. 

Estimated Average Burden per 

Respondent: 20 minutes. 

Frequency of Response: On occasion. 

Estimated Number of Respondents: 

6,667. 

Dated: September 24, 2009. 

By direction of the Secretary. 

Denise McLamb, 

Program Analyst, Enterprise Records Service. 

[FR Doc. E9–23411 Filed 9–28–09; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

[OMB Control No. 2900–0335] 

Proposed Information Collection 

(Dental Record Authorization and 

Invoice for Outpatient Services) 

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 

extension of a currently approved 

collection, and allow 60 days for public 

comment in response to the notice. This 

notice solicits comments on the 

information needed to determine a 

veteran’s dental treatment needs, and 

the fees associated for these services. 

DATES: Written comments and 

recommendations on the proposed 

collection of information should be 

received on or before November 30, 

2009. 

ADDRESSES: Submit written comments 

on the collection of information through 

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. 2900–0335’’ 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 

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. 

Title: Dental Record Authorization 

and Invoice for Outpatient Services, VA 

Form 10–2570d. 

OMB Control Number: 2900–0335. 

Type of Review: Extension of a 

currently approved collection. 

Abstract: VA Form 10–2570d is 

essential to the proper administration of 

VA outpatient fee dental program. The 

associated instructions make it possible 

to communicate with clarity the 

required procedures, peculiarities, and 

precautions associated with VA 

authorizations for contracting with 

private dentists for the provision of 

dental treatment for eligible veteran 

beneficiaries. Since most of the veterans 

who are authorized fee dental care are 

geographically inaccessible to VA dental 

clinics, it is necessary to request 

information as to the veteran’s oral 

condition, treatment needs and the 

usual customary fees for these services 

from the private fee dentist whom the 

veteran has selected. The form lists the 

dental treatment needs of the veteran 

patient, the cost to VA to provide such 

services, and serves as an invoice for 

payment. VA uses the data collected to 

verify the veteran’s eligibility to receive 

dental benefits. 

Affected Public: Business and other 

for profit. 

Estimated Total Annual Burden: 

3,666 hours. 

Estimated Average Burden per 

Respondent: 20 minutes. 

Frequency of Response: On occasion. 

Estimated Number of Respondents: 

11,000. 

Dated: September 24, 2009. 

By direction of the Secretary. 

Denise McLamb, 

Program Analyst, Enterprise Records Service. 

[FR Doc. E9–23412 Filed 9–28–09; 8:45 am] 

BILLING CODE 8320–01–P 


jlentini on DSKJ8SOYB1PROD with NOTICES