Application for Service-Disabled Veterans Insurance

ICR 201010-2900-011

OMB: 2900-0068

Federal Form Document

Forms and Documents
IC Document Collections
IC ID
Document
Title
Status
28215 Modified
ICR Details
2900-0068 201010-2900-011
Historical Active 200804-2900-002
VA 2900-0068
Application for Service-Disabled Veterans Insurance
Revision of a currently approved collection   No
Regular
Approved without change 08/10/2011
Retrieve Notice of Action (NOA) 05/12/2011
  Inventory as of this Action Requested Previously Approved
08/31/2014 36 Months From Approved 08/31/2011
25,000 0 4,250
8,333 0 2,833
0 0 0

These forms are used by veterans to apply for insurance. The data collected is used by VA to determine eligibility for insurance. The information collected is required by law, 38 USC 1922.

US Code: 38 USC 1922 Name of Law: Service Disabled Veterans Insurance
  
None

Not associated with rulemaking

  75 FR 213 11/04/2010
76 FR 46 03/09/2011
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 25,000 4,250 0 0 20,750 0
Annual Time Burden (Hours) 8,333 2,833 0 0 5,500 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
There is a change in respondent burden due to the fact certain medical questions have been removed from the forms. Also, the increase in the burden hours is due to more veterans becoming eligible for this type of insurance, therefore more applications are received and the inclusion of VA Form 29-4364c.

$1,016,825
No
No
No
No
No
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.
05/12/2011


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