Application for Service-Disabled Veterans Insurance (VA Foms 29-0151 & 29-4364)

ICR 201707-2900-004

OMB: 2900-0068

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2018-02-22
Supporting Statement A
2018-02-09
Supplementary Document
2018-02-09
IC Document Collections
ICR Details
2900-0068 201707-2900-004
Active 201310-2900-006
VA VBA-INS-DJ/NK
Application for Service-Disabled Veterans Insurance (VA Foms 29-0151 & 29-4364)
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 06/25/2018
Retrieve Notice of Action (NOA) 03/28/2018
  Inventory as of this Action Requested Previously Approved
06/30/2021 36 Months From Approved
25,000 0 0
8,333 0 0
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

  82 FR 25807 11/30/2017
83 FR 3584 02/22/2018
No

1
IC Title Form No. Form Name
Application for Service-Disabled Veterans Insurance (29-0151, 29-4364) VA Form 29-4364, VA Form 29-0151 Application for Service-Disabled Veterans Insurance ,   Application For Service-Disabled Veterans Insurance

  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 0 0 0 0 25,000
Annual Time Burden (Hours) 8,333 0 0 0 0 8,333
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$2,482,250
No
    Yes
    Yes
No
No
No
Uncollected
Cynthia Harvey - Pryor 202 461-5870 cynthia.harvey-pryor@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.
03/28/2018


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