Notice of Lapse & Application for Reinstatement (29-389 & 29-389-1)

ICR 201411-2900-001

OMB: 2900-0128

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2015-08-21
Supplementary Document
2015-07-20
Supplementary Document
2015-06-10
Supporting Statement A
2015-09-02
Supplementary Document
2015-04-09
IC Document Collections
IC ID
Document
Title
Status
28339 Modified
ICR Details
2900-0128 201411-2900-001
Historical Active 201203-2900-009
VA VBA-INS-DB
Notice of Lapse & Application for Reinstatement (29-389 & 29-389-1)
Revision of a currently approved collection   No
Regular
Approved without change 09/28/2015
Retrieve Notice of Action (NOA) 08/03/2015
  Inventory as of this Action Requested Previously Approved
09/30/2018 36 Months From Approved 09/30/2015
23,352 0 23,352
4,281 0 4,459
0 0 0

These forms are used by an insured to reinstate a lapsed policy.

None
None

Not associated with rulemaking

  80 FR 28 02/11/2015
80 FR 162 08/21/2015
No

1
IC Title Form No. Form Name
Notice of Lapse & Application for Reinstatement 29-389, 29-389-1 Notice of Lapse & Application for Reinstatement ,   Notice of Past Due Payment & Application for Reinstatement

  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 23,352 23,352 0 0 0 0
Annual Time Burden (Hours) 4,281 4,459 0 0 -178 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The previous calculations were corrected and it resulted in a decrease in the respondent burden.

$109,773
No
No
No
No
No
Uncollected
Crystal Rennie 202 632-7492 crystal.rennie@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.
08/03/2015


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