Agency Information Collection (Financial Status Report) Activities Under OMB Review

---
identifier: "/us/fr/2012-16103"
source: "fr"
legal_status: "authoritative_unofficial"
title: "Agency Information Collection (Financial Status Report) Activities Under OMB Review"
title_number: 0
title_name: "Federal Register"
section_number: "2012-16103"
section_name: "Agency Information Collection (Financial Status Report) Activities Under OMB Review"
positive_law: false
currency: "2012-07-02"
last_updated: "2012-07-02"
format_version: "1.1.0"
generator: "[email protected]"
agency: "Veterans Affairs Department"
document_number: "2012-16103"
document_type: "notice"
publication_date: "2012-07-02"
agencies:
  - "Veterans Affairs Department"
fr_citation: "77 FR 39343"
fr_volume: 77
docket_ids:
  - "OMB Control No. 2900-0165"
comments_close_date: "2012-08-01"
fr_action: "Notice."
---


#  Agency Information Collection (Financial Status Report) Activities Under OMB Review

**AGENCY:**

Office of Management, Department of Veterans Affairs.

**ACTION:**

Notice.

**SUMMARY:**

In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice announces that the Office of Management, Department of Veterans Affairs, has submitted 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 August 1, 2012.

**ADDRESSES:**

Submit written comments on the collection of information through *www.Regulations.gov* or to VA's OMB Desk Officer, Office of Information and Regulatory Affairs, New Executive Office Building, Room 10235, Washington, DC 20503 (202) 395-7316. Please refer to “OMB Control No. 2900-0165” in any correspondence.

**FOR FURTHER INFORMATION CONTACT:**

Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632-7479, FAX (202) 632-7634 or email *[email protected].* Please refer to “OMB Control No. 2900-0165.”

**SUPPLEMENTARY INFORMATION:**

*Title:* Financial Status Report, VA Form 5655.

*OMB Control Number:* 2900-0165.

*Type of Review:* Extension of a currently approved collection.

*Abstract:* Claimants complete VA Form 5655 to report their financial status. VA uses the data collected to determine the claimant's eligibility for a waiver of collection, setup a payment plan or for the acceptance of a compromise offer on their VA benefit debt.

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 on April 12, 2012, at page 22068.

*Affected Public:* Individuals or households.

*Estimated Annual Burden:* 57,155 hours.

*Estimated Average Burden Per Respondent:* 1 hour.

*Frequency of Response:* On occasion.

*Estimated Number of Respondents:* 57,155.

By direction of the Secretary.

Dated: June 27, 2012.

Denise McLamb,

Program Analyst, Enterprise Records Service.