Application for Supplemental Service Disabled Veterans Insurance

ICR 200711-2900-001

OMB: 2900-0539

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2007-11-13
IC Document Collections
ICR Details
2900-0539 200711-2900-001
Historical Active 200408-2900-006
VA 2900-0539
Application for Supplemental Service Disabled Veterans Insurance
Extension without change of a currently approved collection   No
Regular
Approved without change 01/02/2008
Retrieve Notice of Action (NOA) 11/13/2007
VA shall continue to work toward providing respondents with a fully electronic option for completing associated forms during this period of clearance.
  Inventory as of this Action Requested Previously Approved
01/31/2011 36 Months From Approved 12/31/2007
10,000 0 10,000
3,333 0 3,333
0 0 0

These forms are used to apply for Supplemental Service Disabled Insurance. The information collected is required by law, 38 USC 1922.

US Code: 38 USC 1922 Name of Law: Service disabled veterans' insurance
   PL: Pub.L. 102 - 568 203 Name of Law: Supplemental Service Disabled Veterans' Insurance For Totally Disabled Veterans
  
None

Not associated with rulemaking

  72 FR 145 07/30/2007
72 FR 196 10/11/2007
No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 10,000 10,000 0 0 0 0
Annual Time Burden (Hours) 3,333 3,333 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$46,493
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Denise McLamb 202-565-8374 denise.mclamb@mail.va.gov

  No

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.
11/13/2007


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