82 FR 8972 - Agency Information Collection Activity Under OMB Review: (Supportive Services for Veteran Families (SSVF) Program Application for Supportive Services Grant)

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 82, Issue 20 (February 1, 2017)

Page Range		8972-8973
FR Document		2017-02078

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 and includes the actual data collection instrument.

Federal Register, Volume 82 Issue 20 (Wednesday, February 1, 2017)

[Federal Register Volume 82, Number 20 (Wednesday, February 1, 2017)]
[Notices]
[Pages 8972-8973]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-02078]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0757]


Agency Information Collection Activity Under OMB Review: 
(Supportive Services for Veteran Families (SSVF) Program Application 
for Supportive Services Grant)

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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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 and includes the actual data collection instrument.

DATES: Comments must be submitted on or before March 3, 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-
0757'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Brian McCarthy, Office of Regulatory 
and Administrative Affairs (10B4) Department of Veterans Affairs, 810 
Vermont Avenue NW., Washington, DC 20420, (202) 461-6345 or email 
[email protected]. Please refer to ``OMB Control No. 2900-0757, 
Proposed Information Collection (Supportive Services for Veteran 
Families (SSVF) Program) Application For Supportive Services Grant).

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. The 60-day Federal Register Notice published on 
Monday, November 28, 2016, Vol. 81, Pages 85693-85694.
    Title: Supportive Services for Veteran Families (SSVF) Program.
    a. Application for Supportive Services Grants VA Form 10-10072.
    b. Participant Satisfaction Survey, VA Form 10-10072a.
    c. Quarterly Grantee Performance Report, VA Form 10-10072b.
    d. Renewal Application. VA Form 10-10072c.
    e. Applicant Budget Template Excel Worksheet.
    f. FY16 Financial Report.
    g. Grantee Certification.
    OMB Control Number: 2900-0757 (Supportive Services for Veteran 
Families (SSVF) Program).
    Type of Review: Revision.
    Abstract: The purpose of the Supportive Services for Veteran 
Families (SSVF) Program is to provide supportive services grants to 
private non-profit organizations and consumer cooperatives who will 
coordinate or provide supportive services to very low-income veteran 
families who are residing in permanent housing, are homeless and 
scheduled to become residents of permanent housing within a specified 
time period, or after exiting permanent housing, are seeking other 
housing that is responsive to such very low-income veteran family's 
needs and preferences.

[[Page 8973]]

    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.
    Affected Public: Individuals or households.
    Estimated Annual Burden: 25,505 hours.
    Estimated Average Burden per Respondent: 62.5 minutes.
    Frequency of Response: One-time.
    Estimated Number of Respondents: 12,270.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Office of Privacy and Records Management, 
Department of Veterans Affairs.
[FR Doc. 2017-02078 Filed 1-31-17; 8:45 am]
 BILLING CODE 8320-01-P

8972 Federal Register / Vol. 82, No. 20 / Wednesday, February 1, 2017 / Notices

With respect to the following Estimated Annual Responses: brian.mccarthy4@va.gov. Please refer to
collection of information, VHA invites a. Enrollment Application for VA ‘‘OMB Control No. 2900–0757, Proposed
comments on: Health Care—VA Form 10–10EZ— Information Collection (Supportive
(1) Whether the proposed collection 540,000. Services for Veteran Families (SSVF)
of information is necessary for the b. Application for Renewal of Health Program) Application For Supportive
proper performance of VHA’s functions, Care Benefits—VA Form 10–10EZR— Services Grant).
including whether the information will 859,000. SUPPLEMENTARY INFORMATION: Under the
have practical utility; (2) the accuracy of c. Request for Hardship PRA of 1995 (Pub. L. 104–13; 44 U.S.C.
VHA’s estimate of the burden of the Determination—VA Form 10–10HS— 3501–3521), Federal agencies must
proposed collection of information; (3) 7,000. obtain approval from the Office of
ways to enhance the quality, utility, and By direction of the Secretary. Management and Budget (OMB) for each
clarity of the information to be Cynthia Harvey-Pryor, collection of information they conduct
collected; and (4) ways to minimize the or sponsor. This request for comment is
Agency Clearance Officer, Office of Privacy
burden of the collection of information and Records Management, Department of being made pursuant to Section
on respondents, including through the Veterans Affairs. 3506(c)(2)(A) of the PRA.
use of automated collection techniques [FR Doc. 2017–02138 Filed 1–31–17; 8:45 am]
With respect to the following
or the use of other forms of information collection of information, VHA invites
BILLING CODE 8320–01–P
technology. comments on: (1) Whether the proposed
Titles: collection of information is necessary
1. Enrollment Application for VA for the proper performance of VHA’s
DEPARTMENT OF VETERANS
Health Care—VA Form 10–10EZ. functions, including whether the
AFFAIRS
2. Application for Renewal of Health information will have practical utility;
Care Benefits—VA Form 10–10EZR. [OMB Control No. 2900–0757] (2) the accuracy of VHA’s estimate of
3. Request for Hardship the burden of the proposed collection of
Determination—VA Form 10–10HS. Agency Information Collection Activity information; (3) ways to enhance the
OMB Control Number: 2900–0091. Under OMB Review: (Supportive quality, utility, and clarity of the
Type of Review: Revision of a Services for Veteran Families (SSVF) information to be collected; and (4)
currently approved collection. Program Application for Supportive ways to minimize the burden of the
Abstracts: Services Grant) collection of information on
a. VA Form 10–10EZ collects respondents, including through the use
information only from new applicants AGENCY: Veterans Health
Administration, Department of Veterans of automated collection techniques or
for VA medical care, nursing home, the use of other forms of information
domiciliary, dental benefits, and new Affairs.
ACTION: Notice.
technology. The 60-day Federal Register
enrollees in the VA health care system. Notice published on Monday, November
b. VA Form 10–10EZR, Health 28, 2016, Vol. 81, Pages 85693–85694.
Benefits Renewal Form, is used to SUMMARY: In compliance with the
Paperwork Reduction Act (PRA) of 1995 Title: Supportive Services for Veteran
collect data from those veterans who Families (SSVF) Program.
wish to update their application data. (44 U.S.C. 3501–3521), this notice
announces that the Veterans Health a. Application for Supportive Services
c. VA Form 10–10HS collects Grants VA Form 10–10072.
information only from veterans who are Administration (VHA), Department of
Veterans Affairs, will submit the b. Participant Satisfaction Survey, VA
in a copay required status for hospital Form 10–10072a.
care and medical services, but due to a collection of information abstracted
c. Quarterly Grantee Performance
loss of income project their income for below to the Office of Management and
Report, VA Form 10–10072b.
the current year will be substantially Budget (OMB) for review and comment. d. Renewal Application. VA Form 10–
below the VA means test limits. The PRA submission describes the 10072c.
Affected Public: Individuals or nature of the information collection and e. Applicant Budget Template Excel
households. its expected cost and burden and Worksheet.
Estimated Annual Burden: includes the actual data collection f. FY16 Financial Report.
a. Enrollment Application for VA instrument. g. Grantee Certification.
Health Care—VA Form 10–10EZ— DATES: Comments must be submitted on OMB Control Number: 2900–0757
270,000 hours. or before March 3, 2017. (Supportive Services for Veteran
b. Application for Renewal of Health Families (SSVF) Program).
ADDRESSES: Submit written comments
Care Benefits—VA Form 10–10EZR— Type of Review: Revision.
on the collection of information through Abstract: The purpose of the
343,600 hours. www.Regulations.gov, or to Office of
c. Request for Hardship Supportive Services for Veteran
Information and Regulatory Affairs, Families (SSVF) Program is to provide
Determination—VA Form 10–10HS— Office of Management and Budget, Attn:
1,750 hours. supportive services grants to private
VA Desk Officer; 725 17th St. NW., non-profit organizations and consumer
Estimated Average Burden per
Washington, DC 20503 or sent through cooperatives who will coordinate or
Respondent:
electronic mail to oira_submission@ provide supportive services to very low-
a. Enrollment Application for VA
omb.eop.gov. Please refer to ‘‘OMB income veteran families who are
Health Care—VA Form 10–10EZ—30
Control No. 2900–0757’’ in any residing in permanent housing, are
sradovich on DSK3GMQ082PROD with NOTICES

minutes.
correspondence. homeless and scheduled to become
b. Application for Renewal of Health
Care Benefits—VA Form 10–10EZR—24 FOR FURTHER INFORMATION CONTACT: residents of permanent housing within
minutes. Brian McCarthy, Office of Regulatory a specified time period, or after exiting
c. Request for Hardship and Administrative Affairs (10B4) permanent housing, are seeking other
Determination—VA Form 10–10HS—15 Department of Veterans Affairs, 810 housing that is responsive to such very
minutes. Vermont Avenue NW., Washington, DC low-income veteran family’s needs and
Frequency of Response: Annually. 20420, (202) 461–6345 or email preferences.

VerDate Sep<11>2014 16:23 Jan 31, 2017 Jkt 241001 PO 00000 Frm 00064 Fmt 4703 Sfmt 4703 E:\FR\FM\01FEN1.SGM 01FEN1

$Federal Register / Vol. 82, No. 20 / Wednesday, February 1, 2017 / Notices 8973 An agency may not conduct or Estimated Annual Burden: 25,505 By direction of the Secretary. sponsor, and a person is not required to hours. Cynthia Harvey-Pryor, respond to a collection of information Estimated Average Burden per Department Clearance Officer, Office of unless it displays a currently valid OMB Respondent: 62.5 minutes. Privacy and Records Management, control number. Frequency of Response: One-time. Department of Veterans Affairs. Affected Public: Individuals or Estimated Number of Respondents: [FR Doc. 2017–02078 Filed 1–31–17; 8:45 am] households. 12,270. BILLING CODE 8320–01–P sradovich on DSK3GMQ082PROD with NOTICES VerDate Sep<11>2014 16:23 Jan 31, 2017 Jkt 241001 PO 00000 Frm 00065 Fmt 4703 Sfmt 9990 E:\FR\FM\01FEN1.SGM 01FEN1$

Document Created: 2017-02-01 00:06:20
Document Modified: 2017-02-01 00:06:20

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 March 3, 2017.
Contact		Brian McCarthy, Office of Regulatory and Administrative Affairs (10B4) Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 461-6345 or email [email protected] Please refer to ``OMB Control No. 2900-0757, Proposed Information Collection (Supportive Services for Veteran Families (SSVF) Program) Application For Supportive Services Grant).
FR Citation		82 FR 8972