Application for Reinstatement and or Total Disability Income Provision

Application for Reinstatement (Lapsed More than 6 Months), Application for Reinstatement (Non Medical - Comparative Health Statement) (VA Forms 29-352 and 29-353)

OMB: 2900-0011

IC ID: 28089

Documents and Forms
Document Name
Document Type
Form
Form
Form
Information Collection (IC) Details

View Information Collection (IC)

Application for Reinstatement and or Total Disability Income Provision 2900-0011
 
No Modified
 
Required to Obtain or Retain Benefits
 
38 CFR 8.22 38 CFR 6.79 38 CFR 8.23 38 CFR 8.8

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form VA Form 29-352 Application for Reinstatement (Insurance lapesed more than 6 months) Government Life Insurance and/or Total Disability Income Provision 29-352(4-28-16).pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 29-353 Application for Reinstatement (Non-medical - Comparative Health Statement) Government Life Insurance 29-353(4-28-16).pdf www.va.gov/vaforms Yes No Fillable Printable

General Government Legislative Functions

 

3,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,000 0 0 0 0 3,000
Annual IC Time Burden (Hours) 1,125 0 0 0 0 1,125
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
© 2025 OMB.report | Privacy Policy