81 FR 89576 - Agency Information Collection Activity Under OMB Review: (VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Programs)
DEPARTMENT OF VETERANS AFFAIRS Federal Register Volume 81, Issue 238 (December 12, 2016)
Federal Register Volume 81, Issue 238 (December 12, 2016)
| Page Range | 89576-89577 | |
| FR Document | 2016-29667 |
[Federal Register Volume 81, Number 238 (Monday, December 12, 2016)] [Notices] [Pages 89576-89577] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2016-29667] ----------------------------------------------------------------------- DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0793] Agency Information Collection Activity Under OMB Review: (VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Programs) 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; it includes the actual data collection instrument. DATES: Comments must be submitted on or before January 11, 2017. ADDRESSES: Submit written comments on the collection of information through www.Regulations.gov, or to Office of Information and Regulatory Affairs, Office of Management and Budget, Attn: VA Desk Officer; 725 17th St. NW., Washington, DC 20503 or sent through electronic mail to [email protected]. Please refer to ``OMB Control No. 2900- 0793'' in any correspondence. FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, (202) 461-5870 or email [email protected]. Please refer to ``OMB Control No. 2900- 0793.'' SUPPLEMENTARY INFORMATION: Titles 1. Academic Verification, VA Form 10-0491. 2. Addendum to Application, VA Form 10-0491a. 3. Annual VA Employment Deferment Verification, VA Form 10-0491c. 4. Education Program Completion Notice Service Obligation Placement, VA Form 10-0491d. 5. Evaluation Recommendation Form, VA Form 10-0491e. 6. HPSP Agreement, VA Form 10-0491f. 7. HPSP/OMPSP Application, VA Form 10-0491g. 8. Notice of Approaching Graduation, VA Form 10-0491h. 9. Notice of Change and/or Annual Academic Status Report, VA Form 10-0491i. 10. Request for Deferment for Advanced Education, VA Form 10-0491j. 11. VA Scholarship Offer Response, VA Form 10-0491k. 12. VIOMPSP Agreement, VA Form 10-0491l. OMB Control Number: 2900-0793. Type of Review: Revision of a currently approved collection. Abstract The information required determines the eligibility or suitability of an applicant desiring to receive an award under the provisions of 38 U.S.C. 7601 through 7619, and 38 U.S.C. 7501 through 7505. The information is needed to apply for the VA Health Professional Scholarship Program or Visual Impairment and Orientation and Mobility Professional Scholarship Program. The VA Health Professional Scholarship Program awards scholarships to students receiving education or training in a direct or indirect healthcare services discipline to assist in providing an adequate supply of such personnel for VA and for the United States. The Visual Impairment and Orientation and Mobility Professional Scholarship Program awards scholarships to students pursuing a program of study leading to a degree in visual impairment or orientation and mobility in order to increase the supply of qualified blind rehabilitation specialists for VA and the Nation. The Federal Register Notice with a 60-day comment period soliciting comments on this collection of information was published at Vol. 81, No. 195, FR 69904 on Friday, October 7, 2016. Affected Public: Individuals or households. Estimate of the Hour Burden for the Collection of Information Applicants ---------------------------------------------------------------------------------------------------------------- Number of x Number of x Number of Equals Number of VA Forms respondents responses Equals minutes (minutes) / by 60 = hours ---------------------------------------------------------------------------------------------------------------- 10-0491g--Application....... 1,500 1 1,500 60 90,000 ......... 1,500 10-0491--Academic 1,500 1 1,500 60 90,000 ......... 1,500 Verification............... 10-0491e--Evaluations & 1,500 2 3,000 50 150,000 ......... 2,500 Recommendations (2)........ 10-0491a--Addendum to 450 (30%) 1 450 10 4,500 ......... 75 Application................ ----------------------------------------------------------------------------------- Total................... ........... ........... ......... ........... ......... ......... 5,575 ---------------------------------------------------------------------------------------------------------------- [[Page 89577]] Applicants Selected To Receive a Scholarship ---------------------------------------------------------------------------------------------------------------- Number of x Number of x Number of Equals Number of VA Forms respondents responses Equals minutes (minutes) / by 60 = hours ---------------------------------------------------------------------------------------------------------------- 10-0491L--Agreement for the 30 1 30 15 450 ......... 8 VIOMPSP.................... 10-0491k--VA Scholarship 30 1 30 10 300 ......... 5 Offer Response............. 10-0491i--Notice of Change 30 1 30 20 600 ......... 10 and/or Annual Academic Status Report.............. 10-0491h--Notice of 30 1 30 10 300 ......... 5 Approaching Graduation..... 10-0491d--Education Program 30 1 30 20 600 ......... 10 Completion Notice/Service Obligation Placement....... 10-0491j--Request for 6 1 6 10 60 ......... 1 Deferment for Advanced Education.................. 10-0491c--Annual VA 30 1 24 10 240 ......... 4 Employment/Deferment Verification............... ----------------------------------------------------------------------------------- Total................... ........... ........... ......... ........... ......... ......... 43 ----------------------------------------------------------------------------------- Grand Total for ........... ........... ......... ........... ......... ......... 5,618 VIOMPSP............ ---------------------------------------------------------------------------------------------------------------- Health Professional Scholarship Program (HPSP) Applicants ---------------------------------------------------------------------------------------------------------------- Number of x Number of x Number of Equals Number of VA Forms respondents responses Equals minutes (minutes) / by 60 = hours ---------------------------------------------------------------------------------------------------------------- 10-0491g--Application....... 5,000 1 5,000 60 300,000 ......... 5,000 10-0491--Academic 5,000 1 5,000 60 300,000 ......... 5,000 Verification............... 10-0491e--Evaluations & 5,000 2 10,000 50 500,000 ......... 8,333 Recommendations (2)........ 10-0491a--Addendum to 1500 (30%) 1 1500 10 15,000 ......... 250 Application................ ----------------------------------------------------------------------------------- Total................... ........... ........... ......... ........... ......... ......... 18,583 ---------------------------------------------------------------------------------------------------------------- Applicants Selected To Receive a Scholarship ---------------------------------------------------------------------------------------------------------------- Numnrt of x Number of x Number of Equals Number of VA Forms respondents responses Equals minutes (minutes) / by 60 = hours ---------------------------------------------------------------------------------------------------------------- 10-0491f--Agreement for the 100 1 100 15 1,500 ......... 25 HPSP....................... 10-0491k--VA Scholarship 100 1 100 10 1,000 ......... 17 Offer Response............. 10-0491i--Notice of Change 100 1 100 20 2,000 ......... 33 and/or Annual Academic Status Report.............. 10-0491h--Notice of 100 1 100 10 1,000 ......... 17 Approaching Graduation..... 10-0491d--Education Program 100 1 100 20 2,000 ......... 33 Completion Notice/Service Obligation Placement....... 10-0491j--Request for 20 1 20 10 200 ......... 3 Deferment for Advanced Education.................. 10-0491c--Annual VA 80 1 80 10 800 ......... 13 Employment/Deferment Verification............... ----------------------------------------------------------------------------------- Total................... ........... ........... ......... ........... ......... ......... 141 ----------------------------------------------------------------------------------- Grand Total for HPSP ........... ........... ......... ........... ......... ......... 18,724 ----------------------------------------------------------------------------------- Grand Total for ........... ........... ......... ........... ......... ......... 24,342 Both VIOMPSP and HPSP....... ---------------------------------------------------------------------------------------------------------------- Frequency of Response: Annually. By direction of the Secretary. Cynthia Harvey-Pryor, Program Specialist, Office of Privacy and Records Management, Department of Veterans Affairs. [FR Doc. 2016-29667 Filed 12-9-16; 8:45 am] BILLING CODE 8320-01-P
![89576 Federal Register / Vol. 81, No. 238 / Monday, December 12, 2016 / Notices
business lines across VA to respond to Administration (VHA), Department of 9. Notice of Change and/or Annual
any questions, complaints, suggestions Veterans Affairs, will submit the Academic Status Report, VA Form 10–
or other issues. An agency may not collection of information abstracted 0491i.
conduct or sponsor, and a person is not below to the Office of Management and 10. Request for Deferment for
required to respond to a collection of Budget (OMB) for review and comment. Advanced Education, VA Form 10–
information unless it displays a The PRA submission describes the 0491j.
currently valid OMB control number. nature of the information collection and 11. VA Scholarship Offer Response,
The Federal Register Notice with a 60- its expected cost and burden; it includes VA Form 10–0491k.
day comment period soliciting the actual data collection instrument.
12. VIOMPSP Agreement, VA Form
comments on this collection of DATES: Comments must be submitted on 10–0491l.
information was published October 4, or before January 11, 2017.
2016, Vol. 81, No. 192, page 68502. OMB Control Number: 2900–0793.
ADDRESSES: Submit written comments
Affected Public: Individuals or on the collection of information through Type of Review: Revision of a
households. www.Regulations.gov, or to Office of currently approved collection.
Estimated Annual Burden: 66,000 Information and Regulatory Affairs, Abstract
hours. Office of Management and Budget, Attn:
Estimated Average Burden per VA Desk Officer; 725 17th St. NW., The information required determines
Respondent: 10 minutes. Washington, DC 20503 or sent through the eligibility or suitability of an
Frequency of Response: Daily. electronic mail to oira_submission@ applicant desiring to receive an award
Estimated Number of Respondents: omb.eop.gov. Please refer to ‘‘OMB under the provisions of 38 U.S.C. 7601
33,000 per month. Control No. 2900–0793’’ in any through 7619, and 38 U.S.C. 7501
By direction of the Secretary. correspondence. through 7505. The information is
needed to apply for the VA Health
Cynthia Harvey-Pryor, FOR FURTHER INFORMATION CONTACT: Professional Scholarship Program or
Program Specialist, Office of Privacy and Cynthia Harvey-Pryor, Enterprise Visual Impairment and Orientation and
Records Management, Department of Records Service (005R1B), Department
Veterans Affairs. Mobility Professional Scholarship
of Veterans Affairs, 810 Vermont Program. The VA Health Professional
[FR Doc. 2016–29666 Filed 12–9–16; 8:45 am] Avenue NW, Washington, DC 20420, Scholarship Program awards
BILLING CODE 8320–01–P (202) 461–5870 or email cynthia.harvey- scholarships to students receiving
pryor@va.gov. Please refer to ‘‘OMB education or training in a direct or
Control No. 2900–0793.’’ indirect healthcare services discipline to
DEPARTMENT OF VETERANS SUPPLEMENTARY INFORMATION:
AFFAIRS assist in providing an adequate supply
Titles of such personnel for VA and for the
[OMB Control No. 2900–0793] United States. The Visual Impairment
1. Academic Verification, VA Form and Orientation and Mobility
Agency Information Collection Activity 10–0491. Professional Scholarship Program
Under OMB Review: (VA Health 2. Addendum to Application, VA awards scholarships to students
Professional Scholarship and Visual Form 10–0491a. pursuing a program of study leading to
Impairment and Orientation and 3. Annual VA Employment Deferment
a degree in visual impairment or
Mobility Professional Scholarship Verification, VA Form 10–0491c.
4. Education Program Completion orientation and mobility in order to
Programs) increase the supply of qualified blind
Notice Service Obligation Placement,
AGENCY: Veterans Health VA Form 10–0491d. rehabilitation specialists for VA and the
Administration, Department of Veterans 5. Evaluation Recommendation Form, Nation. The Federal Register Notice
Affairs. VA Form 10–0491e. with a 60-day comment period soliciting
ACTION: Notice. 6. HPSP Agreement, VA Form 10– comments on this collection of
0491f. information was published at Vol. 81,
SUMMARY: In compliance with the 7. HPSP/OMPSP Application, VA No. 195, FR 69904 on Friday, October 7,
Paperwork Reduction Act (PRA) of 1995 Form 10–0491g. 2016.
(44 U.S.C. 3501–3521), this notice 8. Notice of Approaching Graduation, Affected Public: Individuals or
announces that the Veterans Health VA Form 10–0491h. households.
ESTIMATE OF THE HOUR BURDEN FOR THE COLLECTION OF INFORMATION
APPLICANTS
Number of × Number of × Number of Equals Number of
VA Forms Equals ÷ by 60 =
respondents responses minutes (minutes) hours
10–0491g—Application .......................................... 1,500 1 1,500 60 90,000 ................ 1,500
10–0491—Academic Verification ........................... 1,500 1 1,500 60 90,000 ................ 1,500
10–0491e—Evaluations & Recommendations (2) 1,500 2 3,000 50 150,000 ................ 2,500
10–0491a—Addendum to Application ................... 450 (30%) 1 450 10 4,500 ................ 75
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Total ................................................................ .................... .................... ................ .................... ................ ................ 5,575
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![Federal Register / Vol. 81, No. 238 / Monday, December 12, 2016 / Notices 89577
APPLICANTS SELECTED TO RECEIVE A SCHOLARSHIP
Number of × Number of × Number of Equals Number of
VA Forms Equals ÷ by 60 =
respondents responses minutes (minutes) hours
10–0491L—Agreement for the VIOMPSP ............. 30 1 30 15 450 ................ 8
10–0491k—VA Scholarship Offer Response ........ 30 1 30 10 300 ................ 5
10–0491i—Notice of Change and/or Annual Aca-
demic Status Report ........................................... 30 1 30 20 600 ................ 10
10–0491h—Notice of Approaching Graduation ..... 30 1 30 10 300 ................ 5
10–0491d—Education Program Completion No-
tice/Service Obligation Placement ..................... 30 1 30 20 600 ................ 10
10–0491j—Request for Deferment for Advanced
Education ............................................................ 6 1 6 10 60 ................ 1
10–0491c—Annual VA Employment/Deferment
Verification .......................................................... 30 1 24 10 240 ................ 4
Total ................................................................ .................... .................... ................ .................... ................ ................ 43
Grand Total for VIOMPSP ....................... .................... .................... ................ .................... ................ ................ 5,618
HEALTH PROFESSIONAL SCHOLARSHIP PROGRAM (HPSP)
APPLICANTS
Number of × Number of × Number of Equals Number of
VA Forms Equals ÷ by 60 =
respondents responses minutes (minutes) hours
10–0491g—Application .......................................... 5,000 1 5,000 60 300,000 ................ 5,000
10–0491—Academic Verification ........................... 5,000 1 5,000 60 300,000 ................ 5,000
10–0491e—Evaluations & Recommendations (2) 5,000 2 10,000 50 500,000 ................ 8,333
10–0491a—Addendum to Application ................... 1500 (30%) 1 1500 10 15,000 ................ 250
Total ................................................................ .................... .................... ................ .................... ................ ................ 18,583
APPLICANTS SELECTED TO RECEIVE A SCHOLARSHIP
Numnrt of × Number of × Number of Equals Number of
VA Forms Equals ÷ by 60 =
respondents responses minutes (minutes) hours
10–0491f—Agreement for the HPSP .................... 100 1 100 15 1,500 ................ 25
10–0491k—VA Scholarship Offer Response ........ 100 1 100 10 1,000 ................ 17
10–0491i—Notice of Change and/or Annual Aca-
demic Status Report ........................................... 100 1 100 20 2,000 ................ 33
10–0491h—Notice of Approaching Graduation ..... 100 1 100 10 1,000 ................ 17
10–0491d—Education Program Completion No-
tice/Service Obligation Placement ..................... 100 1 100 20 2,000 ................ 33
10–0491j—Request for Deferment for Advanced
Education ............................................................ 20 1 20 10 200 ................ 3
10–0491c—Annual VA Employment/Deferment
Verification .......................................................... 80 1 80 10 800 ................ 13
Total ................................................................ .................... .................... ................ .................... ................ ................ 141
Grand Total for HPSP ............................. .................... .................... ................ .................... ................ ................ 18,724
Grand Total for Both VIOMPSP and
HPSP ............................................ .................... .................... ................ .................... ................ ................ 24,342
Frequency of Response: Annually. By direction of the Secretary.
Cynthia Harvey-Pryor,
Program Specialist, Office of Privacy and
Records Management, Department of
Veterans Affairs.
[FR Doc. 2016–29667 Filed 12–9–16; 8:45 am]
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BILLING CODE 8320–01–P
VerDate Sep<11>2014 18:59 Dec 09, 2016 Jkt 241001 PO 00000 Frm 00153 Fmt 4703 Sfmt 9990 E:\FR\FM\12DEN1.SGM 12DEN1](https://thefederalregister.org/doc/81_FR_89814/page/2.svg)
Document Created: 2018-02-14 09:05:30
Document Modified: 2018-02-14 09:05:30
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | Notice. | |
| Dates | Comments must be submitted on or before January 11, 2017. | |
| Contact | Cynthia Harvey-Pryor, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, (202) 461-5870 or email [email protected] Please refer to ``OMB Control No. 2900- 0793.'' | |
| FR Citation | 81 FR 89576 |
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