Claim for Disability Insurance Benefits, Government Life Insurance

ICR 200806-2900-003

OMB: 2900-0016

Federal Form Document

Forms and Documents
IC Document Collections
ICR Details
2900-0016 200806-2900-003
Historical Active 200510-2900-003
VA 2900-0016
Claim for Disability Insurance Benefits, Government Life Insurance
Extension without change of a currently approved collection   No
Regular
Approved without change 01/08/2009
Retrieve Notice of Action (NOA) 10/30/2008
  Inventory as of this Action Requested Previously Approved
01/31/2012 36 Months From Approved 01/31/2009
8,100 0 8,100
14,175 0 14,175
0 0 0

This form is designed for use by the insurance activity to determine the insured's eligibility for disability insurance benefits. The information is authorized by law, USC Sections 1912, 1915, 1942, 1948.

US Code: 38 USC 1912 Name of Law: Total Disability Waiver
   US Code: 38 USC 1915 Name of Law: Total Disability Income Provision
   US Code: 38 USC 1942 Name of Law: Plans of Insurance
   US Code: 38 USC 1948 Name of Law: Total Disability Provision
  
None

Not associated with rulemaking

  73 FR 119 06/19/2008
73 FR 172 09/04/2008
No

1
IC Title Form No. Form Name
Claim for Disability Insurance Benefits, Government Life Insurance 29-357 Claim for Disability Insurance Benefits

  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 8,100 8,100 0 0 0 0
Annual Time Burden (Hours) 14,175 14,175 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$39,950
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.
10/30/2008


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