82 FR 16475 - Agency Information Collection Activity Under OMB Review: Presidential Memorial Certificate Form

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 82, Issue 63 (April 4, 2017)

Page Range		16475-16476
FR Document		2017-06574

In compliance with the Paperwork Reduction Act (PRA) of 1995, this notice announces that the National Cemetery Administration (NCA), 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.

Federal Register, Volume 82 Issue 63 (Tuesday, April 4, 2017)

[Federal Register Volume 82, Number 63 (Tuesday, April 4, 2017)]
[Notices]
[Pages 16475-16476]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-06574]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0567]


Agency Information Collection Activity Under OMB Review: 
Presidential Memorial Certificate Form

AGENCY: National Cemetery Administration, Department of Veterans 
Affairs.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995, 
this notice announces that the National Cemetery Administration (NCA), 
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 May 4, 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 
oira_submission@

[[Page 16476]]

omb.eop.gov. Please refer to ``OMB Control No. 2900-0567'' 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 
cynthia.harvey-pryor@va.gov. Please refer to ``OMB Control No. 2900-
0567'' in any correspondence.

SUPPLEMENTARY INFORMATION:
    Title: Presidential Memorial Certificate Form VA Form 40-0247.
    OMB Control Number: 2900-0567.
    Type of Review: Revision of a currently approved collection.
    Abstract: The National Cemetery Administration (NCA) made updates 
to its current VA Form 40-0247. The original VA Form 40-0247 is for 
requests for initial copies of a Presidential Memorial Certificates 
(PMC's). The updates to the form would include the following changes 
with no additional respondent burden:

 Format changes
 SSN or Military Service Number from discharge Documents
 Mailing address, email address, telephone and fax number 
updates
 Wording changed to allow the public to also use the form for 
first time requests

Upon appropriate approval, the NCA Web site will display the updated 
version of the VA Form 40-0247 for public use.

    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 at 82 FRN 06728 on January 19, 2017.
    Affected Public: 125,000.
    Estimated Annual Burden: 6,250 hours.
    Estimated Average Burden Per Respondent: 3 minutes each.
    Frequency of Response: One-time.
    Estimated Number of Respondents: 125,000.

    Authority:  44 U.S.C. 3501-3521.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Enterprise Records Service, Office of 
Quality and Compliance, Department of Veterans Affairs.
[FR Doc. 2017-06574 Filed 4-3-17; 8:45 am]
BILLING CODE 8320-01-P

Federal Register / Vol. 82, No. 63 / Tuesday, April 4, 2017 / Notices 16475

relating to the household income, attest of information was published at 82 FRN FOR FURTHER INFORMATION CONTACT:
to out of pocket medical expenses, attest 8566–8567 on January 26, 2017. Cynthia Harvey-Pryor, Enterprise
to sale of primary home real estate and Affected Public: Individuals or Records Service (005R1B), Department
attest to separation from spouse for the households. of Veterans Affairs, 810 Vermont
income year under the Income Estimated Annual Burden: Avenue NW., Washington, DC 20420, at
Verification Division’s review. The a. Mailed with Veterans’ Initial Letters— 202–461–5870.
Veteran’s signature is required on page HEC Form 200–1A—89,001 hours
b. Mailed with Spouses’ Initial Letters— CORRECTION
2 of HEC Form 200–1A. If the Veteran
has medical/health limitations that does HEC Form 220–1—28,530 hours In FR Doc. FR Doc. 2017–04559,
not enable the Veteran to physically c. Mailed to Veterans When Necessary— published on Wednesday, March 8,
sign the form with a wet signature, the HEC Form 340–1—1,701 hours 2017 at 82FR44, make the following
Veteran must mark an ‘‘X’’ to designate d. Mailed to Veterans When correction. On page 13056, in the third
a signature; two witnesses must verify Necessary—Checklist—761 hours column, in second paragraph section,
Estimated Average Burden Per titled DATES, replace ‘‘DATES: Written
the ‘‘X’’ as the Veteran’s signature. HEC,
Respondent: comments and recommendations on the
IVD will use the completed HEC Form a. Mailed with Veterans’ Initial Letters—
200–1A to assist in verifying the proposed collection of information
HEC Form 200–1A—30 minutes should be received on or before April 7,
Veteran’s correct gross household b. Mailed with Spouses’ Initial Letters—
income to ensure the Veteran is placed 2017,’’ to read as follows:
HEC Form 220–1—20 minutes
in the correct priority group for health c. Mailed to Veterans When Necessary— DATES: Written comments and
care. HEC Form 340–1—15 minutes recommendations on the proposed
The HEC, IVD uses HEC Form 220–1 d. Mailed to Veterans When collection of information should be
(Spouse’s Income Verification Necessary—Checklist—761—15 received on or before May 7, 2017.
Response) to collect income verification minutes Dated: March 29, 2017.
information, as applicable, from the Frequency of Response: Annually. By direction of the Secretary:
Veteran’s spouse by requesting the Estimated Annual Responses: Cynthia Harvey-Pryor,
spouse to verify the listed income on the a. Mailed with Veterans’ Initial Letters—
Department Clearance Officer, Enterprise
form as reported to IVD by IRS/SSA, HEC Form 200–1A—178,002 Records Service, Office of Quality and
report any additional income not b. Mailed with Spouses’ Initial Letters— Compliance, Department of Veterans Affairs.
reported by IRS/SSA and sign and date HEC Form 220–1—85,590
[FR Doc. 2017–06572 Filed 4–3–17; 8:45 am]
the form. If the spouse has medical/ c. Mailed to Veterans When Necessary—
BILLING CODE 8320–01–P
health limitations that does not enable HEC Form 340–1—6,805
the spouse to physically sign the form d. Mailed to Veterans When
with a wet signature, the spouse must Necessary—Checklist—761—3,044
DEPARTMENT OF VETERANS
mark an ‘‘X’’ to designate a signature; Authority: 44 U.S.C. 3501–3521 AFFAIRS
two witnesses must verify the ‘‘X’’ as
By direction of the Secretary. [OMB Control No. 2900–0567]
the Veteran’s signature. HEC, IVD will
use the completed HEC Form 220–1 to Cynthia Harvey-Pryor,
assist in verifying the Veteran’s correct Department Clearance Officer, Enterprise Agency Information Collection Activity
gross household income to ensure the Records Service, Office of Quality and Under OMB Review: Presidential
Veteran is placed in the correct priority Compliance, Department of Veterans Affairs. Memorial Certificate Form
group for health care. [FR Doc. 2017–06573 Filed 4–3–17; 8:45 am]
AGENCY: National Cemetery
The HEC, IVD uses the HEC Form BILLING CODE 8320–01–P
Administration, Department of Veterans
340–1 (Declaration of Representative) Affairs.
for the Veteran and the spouse (if ACTION: Notice.
applicable) to appoint a representative, DEPARTMENT OF VETERANS
authorizing HEC, IVD to release AFFAIRS SUMMARY: In compliance with the
information to a designated appointee [OMB Control No. 2900–0657] Paperwork Reduction Act (PRA) of
for a specific income year. Such 1995, this notice announces that the
information includes confidential Conflicting Interests Certification for National Cemetery Administration
federal tax information, other income, Proprietary Schools Comment Request (NCA), Department of Veterans Affairs,
and medical benefits eligibility related will submit the collection of
AGENCY: Veterans Benefits
information. The Veteran and spouse (if information abstracted below to the
Administration, Department of Veterans
applicable) must sign and date the form. Office of Management and Budget
Affairs.
The HEC, IVD uses the HEC Income (OMB) for review and comment. The
ACTION: Notice; correction. PRA submission describes the nature of
Verification—Additional Information
Checklist to request from the Veteran SUMMARY: The Department of Veterans the information collection and its
any additional information needed to Affairs (VA) published a collection of expected cost and burden; it includes
adjudicate the Income Verification case. information notice in a Federal Register the actual data collection instrument.
The Veteran providing the requested on Wednesday, March 8, 2017 that DATES: Comments must be submitted on
information usually results in the best contained an error. The intent was to or before May 4, 2017.
asabaliauskas on DSK3SPTVN1PROD with NOTICES

interest to the Veteran. publish a 60-day Public Comment ADDRESSES: Submit written comments
An agency may not conduct or notice. on the collection of information through
sponsor, and a person is not required to However, the notice incorrectly stated www.Regulations.gov, or to Office of
respond to a collection of information an insert date 30 days after date of Information and Regulatory Affairs,
unless it displays a currently valid OMB publication in the Federal Register in Office of Management and Budget, Attn:
control number. The Federal Register the DATES section. This document VA Desk Officer; 725 17th St. NW.,
Notice with a 60-day comment period corrects the error by updating the public Washington, DC 20503 or sent through
soliciting comments on this collection comment date. electronic mail to oira_submission@

VerDate Sep<11>2014 16:21 Apr 03, 2017 Jkt 241001 PO 00000 Frm 00142 Fmt 4703 Sfmt 4703 E:\FR\FM\04APN1.SGM 04APN1

$16476 Federal Register / Vol. 82, No. 63 / Tuesday, April 4, 2017 / Notices omb.eop.gov. Please refer to ‘‘OMB original VA Form 40–0247 is for control number. The Federal Register Control No. 2900–0567’’ in any requests for initial copies of a Notice with a 60-day comment period correspondence. Presidential Memorial Certificates soliciting comments on this collection (PMC’s). The updates to the form would of information was published at 82 FRN FOR FURTHER INFORMATION CONTACT: include the following changes with no 06728 on January 19, 2017. Cynthia Harvey-Pryor, Enterprise additional respondent burden: Affected Public: 125,000. Records Service (005R1B), Department of Veterans Affairs, 810 Vermont • Format changes Estimated Annual Burden: 6,250 Avenue NW., Washington, DC 20420, • SSN or Military Service Number from hours. (202) 461–5870 or email cynthia.harvey- discharge Documents Estimated Average Burden Per • Mailing address, email address, Respondent: 3 minutes each. pryor@va.gov. Please refer to ‘‘OMB telephone and fax number updates Frequency of Response: One-time. Control No. 2900–0567’’ in any • Wording changed to allow the public correspondence. Estimated Number of Respondents: to also use the form for first time 125,000. SUPPLEMENTARY INFORMATION: requests Title: Presidential Memorial Upon appropriate approval, the NCA Authority: 44 U.S.C. 3501–3521. Certificate Form VA Form 40–0247. Web site will display the updated By direction of the Secretary. OMB Control Number: 2900–0567. version of the VA Form 40–0247 for Cynthia Harvey-Pryor, Type of Review: Revision of a public use. Department Clearance Officer, Enterprise currently approved collection. An agency may not conduct or Records Service, Office of Quality and Abstract: The National Cemetery sponsor, and a person is not required to Compliance, Department of Veterans Affairs. Administration (NCA) made updates to respond to a collection of information [FR Doc. 2017–06574 Filed 4–3–17; 8:45 am] its current VA Form 40–0247. The unless it displays a currently valid OMB BILLING CODE 8320–01–P asabaliauskas on DSK3SPTVN1PROD with NOTICES VerDate Sep<11>2014 16:21 Apr 03, 2017 Jkt 241001 PO 00000 Frm 00143 Fmt 4703 Sfmt 9990 E:\FR\FM\04APN1.SGM 04APN1$

Document Created: 2017-04-03 23:53:36
Document Modified: 2017-04-03 23:53:36

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 May 4, 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- 0567'' in any correspondence.
FR Citation		82 FR 16475