82 FR 46614 - Agency Information Collection Activity Under OMB Review: General Release for Medical Provider Information to the Department of Veterans Affairs (VA) and Authorization and Consent To Release Information to the Department of Veterans Affairs

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 82, Issue 192 (October 5, 2017)

Page Range		46614-46614
FR Document		2017-21433

In compliance with the Paperwork Reduction Act (PRA) of 1995, this notice announces that the Veterans Benefits Administration, 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 it includes the actual data collection instrument.

Federal Register, Volume 82 Issue 192 (Thursday, October 5, 2017)

[Federal Register Volume 82, Number 192 (Thursday, October 5, 2017)]
[Notices]
[Page 46614]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-21433]



[[Page 46614]]

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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-NEW]


Agency Information Collection Activity Under OMB Review: General 
Release for Medical Provider Information to the Department of Veterans 
Affairs (VA) and Authorization and Consent To Release Information to 
the Department of Veterans Affairs

AGENCY: Veterans Benefits Administration, Department of Veterans 
Affairs.

ACTION: Notice.

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

SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995, 
this notice announces that the Veterans Benefits Administration, 
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 it 
includes the actual data collection instrument.

DATES: Comments must be submitted on or before November 6, 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-
NEW'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor, Enterprise 
Records Service (005R1B), Department of Veterans Affairs, 811 Vermont 
Avenue NW., Washington, DC 20420, (202) 461-5870 or email 
[email protected]. Please refer to ``OMB Control No. 2900-
NEW'' in any correspondence.

SUPPLEMENTARY INFORMATION: 

    Authority: 44 U.S.C. 3501-21.

    Title: General Release for Medical Provider Information to the 
Department of Veterans Affairs (VA) (VA Form 21-4142) and Authorization 
and Consent to Release Information to the Department of Veterans 
Affairs (VA Form 21-4142a).
    OMB Control Number: 2900-NEW.
    Type of Review: New collection.
    Abstract: VA Forms 21-4142 will be used to authorize the disclosure 
of information to the VA and 21-4142a will be used to gather the 
necessary information to request medical provider information to the 
VA.
    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 FR 125 on June 30, 2017, page 30004.
    Affected Public: Individuals or Households.
    Estimated Annual Burden: 11,033.
    Estimated Average Burden per Respondent: 5 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents: 132,400.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Office of Quality, Privacy and Risk, 
Department of Veterans Affairs.
[FR Doc. 2017-21433 Filed 10-4-17; 8:45 am]
 BILLING CODE 8320-01-P

46614 Federal Register / Vol. 82, No. 192 / Thursday, October 5, 2017 / Notices

DEPARTMENT OF VETERANS information to request medical provider FOR FURTHER INFORMATION CONTACT:
AFFAIRS information to the VA. Cynthia Harvey-Pryor, Enterprise
An agency may not conduct or Records Service (005R1B), Department
[OMB Control No. 2900–NEW] sponsor, and a person is not required to of Veterans Affairs, 811 Vermont
respond to a collection of information Avenue NW., Washington, DC 20420,
Agency Information Collection Activity unless it displays a currently valid OMB (202) 461–5870 or email cynthia.harvey-
Under OMB Review: General Release control number. The Federal Register pryor@va.gov. Please refer to ‘‘OMB
for Medical Provider Information to the Notice with a 60-day comment period Control No. 2900–NEW’’ in any
Department of Veterans Affairs (VA) soliciting comments on this collection correspondence.
and Authorization and Consent To of information was published at 82 FR
Release Information to the Department SUPPLEMENTARY INFORMATION:
125 on June 30, 2017, page 30004.
of Veterans Affairs Affected Public: Individuals or Authority: 44 U.S.C. 3501–21.

AGENCY: Veterans Benefits Households. Title: Decision Ready Claims (DRC)
Administration, Department of Veterans Estimated Annual Burden: 11,033. Exam Review (VA Form 21–0985).
Affairs. Estimated Average Burden per OMB Control Number: 2900–NEW.
Respondent: 5 minutes. Type of Review: New collection.
ACTION: Notice.
Frequency of Response: One time. Abstract: VA Form 21–0985 will be
SUMMARY: In compliance with the Estimated Number of Respondents: used to identify the condition(s) that a
Paperwork Reduction Act (PRA) of 132,400. veteran would like VA to schedule a
1995, this notice announces that the By direction of the Secretary. contract examination for in support of
Veterans Benefits Administration, Cynthia Harvey-Pryor, his/her Decision Ready Claim.
Department of Veterans Affairs, will Department Clearance Officer, Office of
An agency may not conduct or
submit the collection of information Quality, Privacy and Risk, Department of sponsor, and a person is not required to
abstracted below to the Office of Veterans Affairs. respond to a collection of information
Management and Budget (OMB) for [FR Doc. 2017–21433 Filed 10–4–17; 8:45 am] unless it displays a currently valid OMB
review and comment. The PRA BILLING CODE 8320–01–P
control number. The Federal Register
submission describes the nature of the Notice with a 60-day comment period
information collection and its expected soliciting comments on this collection
cost and burden and it includes the DEPARTMENT OF VETERANS of information was published at 82 FR
actual data collection instrument. AFFAIRS 142 on July 26, 2017, pages 34748.
DATES: Comments must be submitted on
Affected Public: Individuals or
or before November 6, 2017. [OMB Control No. 2900–NEW] Households.
Estimated Annual Burden: 2,500.
ADDRESSES: Submit written comments
Agency Information Collection Activity Estimated Average Burden per
on the collection of information through Respondent: 15 minutes.
www.Regulations.gov, or to Office of Under OMB Review: Decision Ready
Claims (DRC) Exam Review Frequency of Response: On occasion.
Information and Regulatory Affairs, Estimated Number of Respondents:
Office of Management and Budget, Attn: AGENCY: Veterans Benefits 10,000.
VA Desk Officer; 725 17th St. NW., Administration, Department of Veterans
Washington, DC 20503 or sent through By direction of the Secretary.
Affairs.
electronic mail to oira_submission@ Cynthia Harvey-Pryor,
ACTION: Notice.
omb.eop.gov. Please refer to ‘‘OMB Department Clearance Officer, Office of
Control No. 2900–NEW’’ in any SUMMARY: In compliance with the Quality, Privacy and Risk, Department of
correspondence. Paperwork Reduction Act (PRA) of Veterans Affairs.
1995, this notice announces that the [FR Doc. 2017–21432 Filed 10–4–17; 8:45 am]
FOR FURTHER INFORMATION CONTACT:
Cynthia Harvey-Pryor, Enterprise Veterans Benefits Administration, BILLING CODE 8320–01–P

Records Service (005R1B), Department Department of Veterans Affairs, will
of Veterans Affairs, 811 Vermont submit the collection of information
abstracted below to the Office of DEPARTMENT OF VETERANS
Avenue NW., Washington, DC 20420, AFFAIRS
(202) 461–5870 or email cynthia.harvey- Management and Budget (OMB) for
pryor@va.gov. Please refer to ‘‘OMB review and comment. The PRA [OMB Control No. 2900–0666]
Control No. 2900–NEW’’ in any submission describes the nature of the
correspondence. information collection and its expected Agency Information Collection
cost and burden and it includes the Activity: Information Regarding
SUPPLEMENTARY INFORMATION: actual data collection instrument. Apportionment of Beneficiary’s Award
Authority: 44 U.S.C. 3501–21. DATES: Comments must be submitted on AGENCY: Veterans Benefits
Title: General Release for Medical or before November 6, 2017. Administration, Department of Veterans
Provider Information to the Department ADDRESSES: Submit written comments Affairs.
of Veterans Affairs (VA) (VA Form 21– on the collection of information through ACTION: Notice.
4142) and Authorization and Consent to www.Regulations.gov, or to Office of
Release Information to the Department Information and Regulatory Affairs, SUMMARY: Veterans Benefits
ethrower on DSK3G9T082PROD with NOTICES

of Veterans Affairs (VA Form 21–4142a). Office of Management and Budget, Attn: Administration, Department of Veterans
OMB Control Number: 2900–NEW. VA Desk Officer; 725 17th St. NW., Affairs (VA), is announcing an
Type of Review: New collection. Washington, DC 20503 or sent through opportunity for public comment on the
Abstract: VA Forms 21–4142 will be electronic mail to oira_submission@ proposed collection of certain
used to authorize the disclosure of omb.eop.gov. Please refer to ‘‘OMB information by the agency. Under the
information to the VA and 21–4142a Control No. 2900–NEW’’ in any Paperwork Reduction Act (PRA) of
will be used to gather the necessary correspondence. 1995, Federal agencies are required to

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Document Created: 2017-10-05 00:53:27
Document Modified: 2017-10-05 00:53:27

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 November 6, 2017.
Contact		Cynthia Harvey-Pryor, Enterprise Records Service (005R1B), Department of Veterans Affairs, 811 Vermont Avenue NW., Washington, DC 20420, (202) 461-5870 or email [email protected] Please refer to ``OMB Control No. 2900- NEW'' in any correspondence.
FR Citation		82 FR 46614