# Agency Information Collection (Supplement to VA Form 21P-4703) Activity Under OMB Review
**AGENCY:**
Veterans Benefits Administration, 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 Veterans Benefits Administration (VBA), 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; it includes the actual data collection instrument.
**DATES:**
Comments must be submitted on or before November 30, 2015.
**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. 2900-0319” in any correspondence.
**FOR FURTHER INFORMATION CONTACT:**
Crystal Rennie, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632-7492 or email *[email protected]* . Please refer to “OMB Control No. 2900-0319.”
**SUPPLEMENTARY INFORMATION:**
*Title:* Supplement to VA Form 21P-4703.
*OMB Control Number:* 2900-0319.
*Type of Review:* Revision of a currently approved collection.
*Abstract:* VA maintains supervision of the distribution and use of VA benefits paid to fiduciaries on behalf of VA claimants who are incompetent, a minor, or under legal disability. This form is used as a legal contract between VA and a federal fiduciary. It outlines the responsibilities of the fiduciary with respect to the uses of VA funds.
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 80 FR 46388 on August 4, 2015.
*Affected Public:* Individuals or households.
*Estimated Annual Burden:* 3,917.
*Estimated Average Burden per Respondent:* 5 minutes.
*Frequency of Response:* One time.
*Estimated Number of Respondents:* 47,000.
By direction of the Secretary.
Kathleen M. Manwell,
Program Analyst, VA Privacy Service, Office of Privacy and Records Management Department of Veterans Affairs.