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OMB ID: [OMB Control No. 2900-0556]
SUBJECT CATEGORY: Agency Information Collection (Living Will and Durable Power of Attorney for Health Care) Activities Under OMB Review
DOCUMENT SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995
(44 U.S.C. 35013521), 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
[[Page 42924]]
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.
SUMMARY: Agency Information Collection Activities; Proposals, Submissions, and Approvals,
Title: VA Advance Directive: Living Will and Durable Power of Attorney for Health Care, VA Form 100137.
OMB Control Number: 29000556.
Abstract: Claimants admitted to a VA medical facility complete VA Form 100137 to appoint a health care agent to make decisions about his or her medical treatment and to record specific instructions about their treatment preferences in the event they no longer can express their preferred treatment. VA's health care professionals use the data to carry out the claimant's wish.
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
60day comment period soliciting comments on this collection of information was published on May 14, 2008 at page 27894.
Affected Public: Individuals or households.
Estimated Total Annual Burden: 171,811 hours.
Estimated Average Burden per Respondent: 30 minutes.
Frequency of Response: One time.
Estimated Number of Respondents: 343,622.
Dated: July 15, 2008.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Records Management Service.
[FR Doc. E816809 Filed 72208; 8:45 am]
BILLING CODE 832001P
FOR FURTHER INFORMATION CONTACT Denise McLamb, Records Management Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 4617485, fax (202) 2730443 or email denise.mclamb@mail.va.gov. Please refer to ``OMB Control No. 2900 0556.''
14 CFR Part 39 40 CFR Part 52 14 CFR Part 71 33 CFR Part 165 50 CFR Part 679 47 CFR Part 73 26 CFR Part 1 40 CFR Part 180 33 CFR Part 117 50 CFR Part 17 44 CFR Part 67 50 CFR Part 648 14 CFR Part 97 40 CFR Part 63 33 CFR Part 100 50 CFR Part 622 50 CFR Part 660 26 CFR Part 301 44 CFR Part 65 39 CFR Part 111 40 CFR Part 300 6 CFR Part 5 40 CFR Part 271 47 CFR Part 64 40 CFR Parts 52 and 81 50 CFR Part 665 10 CFR Part 50 44 CFR Part 64 49 CFR Part 571 39 CFR Part 3020