# Agency Information Collection Activity Under OMB Review: Notice to Department of Veterans Affairs of Veteran or Beneficiary Incarcerated in Penal Institution
**AGENCY:**
Veterans Benefits Administration, Department of Veterans Affairs.
**ACTION:**
Notice.
**SUMMARY:**
In compliance with the Paperwork Reduction Act (PRA) of 1995, 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, and it includes the actual data collection instrument.
**DATES:**
Comments and recommendations for the proposed information collection should be sent by September 29, 2025.
**ADDRESSES:**
To submit comments and recommendations for the proposed information collection, please type the following link into your browser: *www.reginfo.gov/public/do/PRAMain,* select “Currently under Review—Open for Public Comments”, then search the list for the information collection by Title or “OMB Control No. 2900-0116.”
**FOR FURTHER INFORMATION CONTACT:**
VA PRA information: Dorothy Glasgow, 202-461-1084, *[email protected].*
**SUPPLEMENTARY INFORMATION:**
*Title:* Notice to Department of Veterans Affairs of Veteran or Beneficiary Incarcerated in Penal Institution (VA Form 21-4193).
*OMB Control Number:* 2900-0116. *https://www.reginfo.gov/public/do/PRASearch.*
*Type of Review:* Revision of a currently approved collection.
*Abstract:* VA Form 21-4193 is used to gather the necessary information to determine whether VA benefits should be reduced or terminated based on incarceration of the beneficiary. Without this collection of information, VA would be unable to accurately adjust the rates of incarcerated beneficiaries and overpayments would result. No changes have been made to this form. The respondent burden has increased due to the estimated number of receivables averaged over the past year.
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 90 FR 27758, June 27, 2025.
*Affected Public:* Individuals or Households.
*Estimated Annual Burden:* 2,488 hours.
*Estimated Average Burden per Respondent:* 15 minutes.
*Frequency of Response:* One time.
*Estimated Number of Respondents:* 9,953 per year.
*Authority:* 44 U.S.C. 3501 *et seq.*
Shunda Willis,
Acting, VA PRA Clearance Officer, (Alt.) Office of Enterprise and Integration/Data Governance Analytics, Department of Veterans Affairs.