OMB29-541(6-12-08)

SUPPORTING STATEMENT

VA FORM 29-541

CERTIFICATE SHOWING RESIDENCE AND HEIRS OF DECEASED

VETERANS OR BENEFICIARY

2900-0469

JUSTIFICATION:

1. The form is used by the Department of Veterans Affairs (VA) to establish entitlement to Government Life Insurance proceeds in estate cases when formal administration of the estate is not required. The information on the form is required by law, Title 38, U.S.C. Sections 1917 and 1950.

2. The information collected on the form is used by the Department of Veterans Affairs (VA) to determine entitlement to Government Life Insurance proceeds.

3. This form is available on our website “http://www.va.gov/vaforms/” in a fillable/savable PDF format. Due to low usage and privacy concerns, this form currently cannot be submitted electronically.

4. The information is not contained in any other VA records. Similar information is not available elsewhere.

5. The information does not involve any small businesses.

6. The form is used by VA to solicit information regarding entitlement to proceeds.

7. There are no special circumstances requiring that the collection of information be conducted in a manner inconsistent with the guidelines in 5 CFR Section 1320.6.

8. The Department notice was published in the Federal Register on March 25, 2008, Volume 70, Number 3, Page 940. There were no comments received.

9. The information collected is supplied by the respondent. No remuneration is made.

10. The information collection conforms to the Privacy Act of 1974 and is subject to the conditions of disclosure contained therein. The records are maintained in the system identified as 36VA00, “Veterans and Armed Forces Personnel United States Government Life Insurance Records - VA” as contained in the Privacy Act Issuances, 1993 Compilation.

11. There are no questions of a sensitive nature.

12. We estimate that approximately 2,078 forms a year will be received. We also estimate that it will take approximately 30 minutes to complete this form. We arrived at this estimate by initiating a trial with a VA staff member unfamiliar with the form. The annual burden is 1,039 hours. The cost to the reporting public is $15,585.00 (1,039 hours X $15/hour).

13. This submission does not involve any record keeping costs.

14. Cost to Government:

$1,096.00 Estimated mailing cost (2,078 X 2 minutes per

form X $7.45/hour (average salary for station

mail personnel) plus 2,078 X 27.9 cents each

(presort discount)).

$548.00 Estimated cost for collections (2,078 X 2 minutes

per X $7.91/hour (average salary of station collections

personnel)).

$6,733.00 Estimated cost for processing (2,078 forms X 15

minutes per form X $12.96/hour (average salary

for reviewers)).

$90.00 Estimated printing costs (3,000 X $30/1,000 forms).

$8,467.00 Total cost to the Government.

15. There is no change in respondent burden.

16. The information is collected for insurance purposes only and there are no plans for publication.

17. The collection instrument, VA Form 29-541, may be reproduced and/or stocked by the respondents and veteran service organizations. This VA form does not display an expiration date, and if required to do so would result in unnecessary waste of existing stock of this form. This form is submitted to OMB for approval every three years. As such, this date requirement would also result in an unnecessary burden on the respondents and would delay Department action on the benefit being sought. VA also seeks to minimize its cost to itself of collecting, processing and using the information by not displaying the expiration date. For the reasons stated, VA continues to seek an exemption that waives the displaying of the expiration date on this VA Form.

18. There are no exceptions to the certification statement identified in Item 19 of

OMB Form 83-I.

Statistical Methods

This collection of information does not employ statistical methods.