In the next
submission of this collection to OMB for review VA shall report on
the status of Agency efforts to provide respondents with a fully
electronic process for submitting associated forms including
recongition of electronic signatures.
Inventory as of this Action
Requested
Previously Approved
03/31/2009
03/31/2009
03/31/2006
244
0
244
61
0
61
0
0
0
This form letter is used to request
medical information from the insured's doctor or hospital in
connection with disability insurance benefits. 38 USC 1912, 1915,
1942 and 1948.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.