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###### Department of Veterans Affairs

          - [OMB Control No. 2900-0826]

# AGENCY:

Veterans Benefits Administration, Department of Veterans Affairs.

# ACTION:

Notice.

# SUMMARY:

                        The Veterans Benefits Administration (VBA), 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 revision of a currently approved collection, and allow 60 days for public comment in response to the notice. VA Form 21-0966 will be used by claimants and/or their authorized representatives to indicate an intent to file a claim for compensation and/or pension, or survivors pension and/or DIC, to establish an effective date for an award granted in association with a complete claim filed within 1 year of such form.                    

# DATES:

Written comments and recommendations on the proposed collection of information should be received on or before April 13, 2015.

# ADDRESSES:

                        Submit written comments on the collection of information through Federal Docket Management System (FDMS) at                         *www.Regulations.gov*                         or to Nancy J. Kessinger, Veterans Benefits Administration (20M33), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420 or email to                         *nancy.kessinger@va.gov.*                         Please refer to “OMB Control No. 2900-0826” in any correspondence. During the comment period, comments may be viewed online through the FDMS.                    

# FOR FURTHER INFORMATION CONTACT:

Nancy J. Kessinger at (202) 632-8924 or FAX (202) 632-8925.

# 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, 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:*                     Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC (VA Form 21-0966).                

*OMB Control Number:*                     2900-0826.                

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

*Abstract:*                     VA Form 21-0966 will be used by claimants and/or their authorized representatives to indicate intent to file a claim for compensation and/or disability benefits to establish an effective date for an award granted in association with a complete claim filed within 1 year of such form. VA will use this form to identify claimants in its internal business operational systems to record the date of receipt of this document for the purposes of establishing a date of claim for a complete claim that is filed within 1 year. VA also uses the information to furnish the claimant with the appropriate VA form or application for VA benefits.                

*Affected Public:*                     Individuals or households.                

*Estimated Annual Burden:*                     181,140.                

*Estimated Average Burden per Respondent:*                     15 minutes.                

*Frequency of Response:*                     One time.                

*Estimated Number of Respondents:*                     724,561.                

Dated: February 5, 2015.

By direction of the Secretary.

Crystal Rennie,

VA Clearance Officer, Department of Veterans Affairs.

[FR Doc. 2015-02677 Filed 2-9-15; 8:45 am]

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