Change Requests

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Authorization to Disclose Personal Information to a Third Party (VA Form 21-0845)

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VA Form 21-0845 is used to release information in its custody or control in the following circumstances: where the individual identifies the information and consents to its use; for the purpose for which it was collected or a consistent purpose (i.e., a purpose which the individual might have reasonably expected). By law, VA must have a claimants or beneficiary’s written permission (an "authorization") to use or give out claim or benefit information for any purpose that is not contained in VA’s System of Records, 58VA21/22/28 Compensation, Pension, Education and Veterans Readiness and Employment Records. The claimant or beneficiary may revoke the authorization at any time, except if VA has already acted based on the claimant’s permission.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

5 USC 552a	View Law

38 USC 5701	View Law

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Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC (VA Form 21-0966)

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VA Form 21-0966 is used by claimants and/or their authorized representatives to indicate intent to file a claim for disability benefits to establish an effective date for an award granted in association with a complete claim filed within one year of such form. VA uses this form to identify claimants in its internal business operational systems to record the date of receipt of this document for the purposes of establishing a date of claim for a complete claim that is filed within one year. VA also uses the information to furnish the claimant with the appropriate VA form or application for VA benefits.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

38 USC 5102	View Law

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Record of Emergency Data

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Title 10 United States Code §§ 655, 1475-1478, 1482, designate beneficiaries for certain benefits in the event of the Service member’s death, a guide for disposition of a member’s pay and allowances if captured, missing or interned and to expedite the notification process in the event of an emergency and/or the death of the member.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

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Environmental Justice Thriving Communities Grantmaking Program: Applications for Subawards November Launch

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To meet the goals and objectives that demonstrate the U.S. Environmental Protection Agency (EPAs) and the Administrations commitment to achieving environmental justice and embedding environmental justice into Agency programs, the Environmental Justice Thriving Communities Grantmaking Program provides about $600 million in 11 cooperative agreements funding to Grantmakers who will function as pass-through entities for the Environmental Justice Thriving Communities Subgrants (2 CFR Parts 200 and 1500). Each Grantmaker will collaborate with EPA to design and build their own processes to receive and evaluate applications to fund the initial development of community-led environmental justice projects.Emergency Justfication:With this Information Collection Request (ICR), EPA seeks emergency clearance by October 31, 2024 for six Grantmakers to solicit applications for their first round of subgrants to be launched in October 2024. EPA cannot reasonably comply with the normal clearance procedures because the time between the Grantmakers receipt of their funding awards and the launch of their subaward programs (3 months) does not allow sufficient time to obtain PRA clearance using the standard ICR process (which typically takes 6-9 months). Collection of the information requested under this emergency clearance (i.e., applications) is essential for the Grantmakers to have a mechanism for selecting and distributing subaward grants to fund environmental justice projects in underserved communities, thus fulfilling the central objective of the program. The six-month emergency clearance period will cover the first round of subaward applications that will be solicited by six Grantmakers in October 2024. Subsequent rounds of applications for these six Grantmakers will be authorized via a Standard ICR package for the Grantmaking Program that will be submitted for review via the standard ICR approval process.

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Peace Corps Volunteer Authorization for Examination and/or Treatment

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Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

5 USC 8142

5 USC 8101 et.seq

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Coast Guard Boating Accident Report Form (CG-3865)

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This report is submitted by State reporting authorities to the USCG. Data collected from these reports are used to establish USCG Marine Safety performance measures and publish statistics in accordance with Title 46 USC 6102.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

46 USC 6102	View Law

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Form 1041-N - U.S. Income Tax Return for Electing Alaska Native Settlement Trusts

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An Alaska Native Settlement Trust (ANST) may elect under section 646 to have the special income tax treatment of that section apply to the trust and its beneficiaries. This one-time election is made by filing Form 1041-N. Form 1041-N is used by the ANST to report its income, etc., and to compute and pay any income tax. Form 1041-N is also used for the special information reporting requirements that apply to ANSTs.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

26 USC 646	View Law

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Diversions, Return Flow, and Consumptive Use of Colorado River Water in the Lower Colorado River Basin

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The United States is required to collect this information by the Supreme Court and requires water users to report this information under water delivery contracts.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

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Approval of Laboratories for Conducting Aquatic Animal Tests for Export Health Certificates

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The purpose of this information collection is to provide approval to laboratories to conduct tests for the export of aquatic animals. The information collection activities permit APHIS to vet the laboratories.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

7 USC 8301	View Law

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Annual Daylight Overdraft Capital Report for U.S. Branches and Agencies of Foreign Banks

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The FR 2225 is required for foreign banking organizations (FBOs) that wish to, and are eligible to, establish a non-zero net debit cap for their U.S. branches and agencies under the Federal Reserve Policy on Payment System Risk (PSR policy).

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

12 USC 347d	View Law

12 USC 248(i)	View Law

12 USC 248-1	View Law

12 USC 464	View Law

12 USC 3105(a)	View Law

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Reporting, Recordkeeping, and Disclosure Requirements Associated with Regulation NN

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The Board’s Regulation NN - Retail Foreign Exchange Transactions (12 CFR Part 240) establishes rules appliable to retail foreign currency transactions engaged in by state member banks, uninsured state-licensed branches of foreign banks, financial holding companies, bank holding companies, savings and loan holding companies, agreement corporations, and Edge corporations (collectively, banking institutions). Regulation NN includes certain reporting, recordkeeping, and disclosure requirements for banking institutions that elect to provide foreign currency exchange services to retail consumers.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

12 USC 1467a(g)	View Law

12 USC 625	View Law

12 USC 601-604a	View Law

7 USC 2(c)(2)(E)	View Law

12 USC 248	View Law

12 USC 3106a	View Law

12 USC 3108	View Law

12 USC 1844(b)	View Law

12 USC 1844(c)	View Law

12 USC 1467a(b)	View Law

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Pentagon Facilities Access Control System

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The Pentagon Force Protection Agency (PFPA) must establish the identity of all individuals, including contractors and visitors, seeking access to the Pentagon and Pentagon facilities. PFPA must also determine that a legitimate need for access exists and that individuals seeking access meet minimum suitability standards including passing a National Crime Information Center background check.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

10 USC 2674	View Law

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ICE Flight Manifest/Billing Agreement

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OMB Circular A-126, Subject: Improving the Management and Use of Government Aircraft (May 22, 1992), requires that government agencies that fly non-official passengers in a Space Available status charge them the “full coach fare” cost of their seat on the government aircraft. Circular A-126 defines “full coach fare” as “a coach fare available to the general public between the day that the travel was planned and the day that the travel occurred.” Id. ¶ 4f. To properly bill these passengers, ICE must set up accounts receivable in the Federal Financial Management System (FFMS). Accounts receivable must be based on legally valid debts. The Flight Manifest/Billing Agreement (FM/BA) form will collect the contact information needed to send bills to these passengers from FFMS, and will document their agreement to be billed for their seats on these flights. The ICE Flight Manifest Information/Agreement To Reimburse form is used to collect information from members of the public, contractors, Federal employees, or dependents who intend to board ICE-chartered aircraft for purposes of evacuation. The purposes of the data collected on this form are two-fold. First, ICE will verify the individual’s identity before he/she boards an ICE-chartered aircraft to assess the safety of the aircraft, its crew, other passengers, and the United States. Further, the data collected on the form is also used in the event of an emergency to help ensure timely notification of points of contact designated by the passenger. Second, the form will confirm the agreement of Space Available passengers to be billed for their travel, and establish the names, addresses, and Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN) for billing and collection purposes. The ICE Senior Field Official(s) at the airfield of embarkation will collect pertinent data for flight manifest information from all persons wishing to fly on an ICE-chartered aircraft prior to their boarding of the aircraft. Only passengers flying in a Space Available status, that is, private persons not on official government travel orders, will be required to complete the relevant fields on the form stating the reason for Space Available travel and requesting their signature to document their agreement to be billed for their travel. In special emergency situations, the form may be completed in-flight. The ICE Senior Field Official(s) will then submit the completed forms and the flight manifest to the program office that chartered the flight and to the Emergency Management Unit via email, as soon as practicable upon completion of the flight.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

5 USC 301	View Law

49 USC 44909	View Law

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U.S. Domestic Hemp Production Program

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Reporting Requirements would support the operation and administration of the U.S. Domestic Hemp Production Program

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

7 USC 1621	View Law

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National Incident-Based Reporting System (NIBRS)

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Under Title 28, United States Code (U.S.C.), Section (§) 534 and 34 U.S.C. § 41303, this collection requests incident-based data from law enforcement agencies in order for the FBI UCR Program to collect and disseminate NIBRS data.

Federal Register Notices

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30-Day FRN	View Notice

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Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

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This collection of information is necessary to enable the Agency to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs.

Federal Register Notices

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30-Day FRN	View Notice

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