Matured Endowment Notification (VA Form 29-5767)

ICR 201708-2900-023

OMB: 2900-0159

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2018-02-13
Supporting Statement A
2017-10-04
Supplementary Document
2017-10-04
IC Document Collections
IC ID
Document
Title
Status
28391 Modified
ICR Details
2900-0159 201708-2900-023
Active 201307-2900-002
VA VBA-INS-NK
Matured Endowment Notification (VA Form 29-5767)
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 06/25/2018
Retrieve Notice of Action (NOA) 03/22/2018
  Inventory as of this Action Requested Previously Approved
06/30/2021 36 Months From Approved
8,600 0 0
2,867 0 0
4,214 0 0

The VA Form 29-5767 is used to notify the insured that the policy has matured.

US Code: 38 USC 1952 Name of Law: Optional settlements
   US Code: 38 USC 1917 Name of Law: Insurance maturing after August 1, 1946
  
None

Not associated with rulemaking

  82 FR 19990 09/20/2017
83 FR 2076 02/02/2018
No

1
IC Title Form No. Form Name
Matured Endowment Notification (29-5767) VA Form 29-5767 Application for Payment of Matured Endowment

  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 8,600 0 0 0 0 8,600
Annual Time Burden (Hours) 2,867 0 0 0 0 2,867
Annual Cost Burden (Dollars) 4,214 0 0 0 0 4,214
No
No

$205,668
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.
03/22/2018


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