Regulacje i polityka gospodarcza · 20.11.1996

Agency Information Collection: Submission for OMB Review; Comment Request

The Veterans Benefits Administration (VBA), Department of Veterans Affairs, has submitted to the Office of Management and Budget (OMB) the following proposal for the collection of information under the provisions of the Paperwork Reduction Act (44 U.S.C. Chapter 35). OMB Control Number: 2900-0104. Title and Form Number: Report of Accidental Injury in Support of Claim for Compensation or Benefits, VA Form 21-4176. Type of Review: Extension of a currently approved collection. Need and Uses: The form is used in support of claims for disability benefits based on a disability which is the result of an accident. The information given by the veteran is used as a source to gather specific data regarding the accident and to afford the veteran an opportunity to provide information from his or her own knowledge regarding the accident. Affected Public: Individuals or households. Estimated Annual Burden: 2,200 hours. Estimated Average Burden Per Respondent: 30 minutes. Frequency of Response: On occasion Estimated Number of Respondents: 4,400.