OMB Control No: 2900-0166
ICR Reference No:
202105-2900-011
Status: Received in OIRA
Previous ICR Reference No: 201711-2900-002
Agency/Subagency: VA
Agency Tracking No: VBA-INS-YA
Title: Application for Ordinary Life
Insurance (Age 65 and 70) (VA Forms 29-8485 & a; 29-8700, a, b,
c, d & e; and 29-8701, a, b, c, d & e)
Type of Information Collection:
Reinstatement with change of a previously approved collection
Common Form ICR: No
Type of Review Request: Regular
Date Submitted to OIRA:
08/12/2021
Requested
Previously Approved
Expiration Date
36 Months From Approved
Responses
15,400
0
Time Burden (Hours)
1,284
0
Cost Burden (Dollars)
0
0
Abstract: These forms are used by the insured to
apply for replacement insurance for Modified Life at Age 65 and
70.
Authorizing Statute(s): US Code:
38
USC 1904 Name of Law: Plans of Insurance
Citations for New Statutory
Requirements: None
Associated Rulemaking
Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices &
Comments
60-day Notice:
Federal Register Citation:
Citation Date:
86 FR
30685
06/09/2021
30-day Notice:
Federal Register Citation:
Citation Date:
86 FR
44479
08/12/2021
Did the Agency receive public comments on
this ICR? No
Number of Information Collection (IC) in this
ICR: 1
IC Title
Form No.
Form Name
Application for
Ordinary Life Insurance (Age 65 and 70) (29-8485 & a; 29-8700,
a, b, c, d & e; and 29-8701, a, b, c, d & e)
29-8485, 29-8485a, 29-8700, 29-8700a, 29-8700b, 29-8700c,
29-8700d, 29-8700e, 29-8701, 29-8701a, 29-8701b, 29-8701c,
290-8701d, 29-8701e
APPLICATION FOR
ORDINARY LIFE INSURANCE REPLACEMENT INSURANCE FOR MODIFIED LIFE
REDUCED AT AGE 65 NATIONAL SERVICE LIFE INSURANCE ,
Application for
Ordinary Life Insurance Replacement Insurance for Modified Life
Reduced at Age 70 National Service Life Insurance ,
APPLICATION FOR
ORDINARY LIFE INSURANCE REPLACEMENT INSURANCE FOR MODIFIED LIFE
REDUCED AT AGE 65 NATIONAL SERVICE LIFE INSURANCE ,
APPLICATION FOR
ORDINARY LIFE INSURANCE REPLACEMENT INSURANCE FOR MODIFIED LIFE
REDUCED AT AGE 65 NATIONAL SERVICE LIFE INSURANCE ,
APPLICATION FOR
ORDINARY LIFE INSURANCE REPLACEMENT INSURANCE FOR MODIFIED LIFE
REDUCED AT AGE 65 NATIONAL SERVICE LIFE INSURANCE ,
APPLICATION FOR
ORDINARY LIFE INSURANCE REPLACEMENT INSURANCE FOR MODIFIED LIFE
REDUCED AT AGE 65 NATIONAL SERVICE LIFE INSURANCE ,
APPLICATION FOR
ORDINARY LIFE INSURANCE REPLACEMENT INSURANCE FOR MODIFIED LIFE
REDUCED AT AGE 65 NATIONAL SERVICE LIFE INSURANCE ,
APPLICATION FOR
ORDINARY LIFE INSURANCE REPLACEMENT INSURANCE FOR MODIFIED LIFE
REDUCED AT AGE 65 NATIONAL SERVICE LIFE INSURANCE ,
APPLICATION FOR
ORDINARY LIFE INSURANCE REPLACEMENT INSURANCE FOR MODIFIED LIFE
REDUCED AT AGE 70 NATIONAL SERVICE LIFE INSURANCE ,
APPLICATION FOR
ORDINARY LIFE INSURANCE REPLACEMENT INSURANCE FOR MODIFIED LIFE
REDUCED AT AGE 70 NATIONAL SERVICE LIFE INSURANCE ,
APPLICATION FOR
ORDINARY LIFE INSURANCE REPLACEMENT INSURANCE FOR MODIFIED LIFE
REDUCED AT AGE 70 NATIONAL SERVICE LIFE INSURANCE ,
APPLICATION FOR
ORDINARY LIFE INSURANCE REPLACEMENT INSURANCE FOR MODIFIED LIFE
REDUCED AT AGE 70 NATIONAL SERVICE LIFE INSURANCE ,
APPLICATION FOR
ORDINARY LIFE INSURANCE REPLACEMENT INSURANCE FOR MODIFIED LIFE
REDUCED AT AGE 70 NATIONAL SERVICE LIFE INSURANCE ,
APPLICATION FOR
ORDINARY LIFE INSURANCE REPLACEMENT INSURANCE FOR MODIFIED LIFE
REDUCED AT AGE 70 NATIONAL SERVICE LIFE INSURANCE
ICR Summary of Burden
Total Request
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
15,400
0
0
0
0
15,400
Annual Time Burden (Hours)
1,284
0
0
0
0
1,284
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency
Discretion: No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency
Discretion: No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government: $85,370
Does this IC contain surveys, censuses, or employ
statistical methods? No
Does this ICR request any personally identifiable
information (see OMB Circular No. A-130 for an
explanation of this term)? Please consult with your agency's
privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act
Statement (see 5
U.S.C. §552a(e)(3) )? Please consult with your agency's privacy
program when making this determination.
Yes
Is this ICR related to the Affordable Care Act [Pub. L.
111-148 & 111-152]? No
Is this ICR related to the Dodd-Frank Wall Street Reform
and Consumer Protection Act, [Pub. L. 111-203]? No
Is this ICR related to the American Recovery and
Reinvestment Act of 2009 (ARRA)? No
Is this ICR related to the Pandemic Response?
No
Agency Contact: Maribel Aponte 202 266-4688
maribel.aponte@va.gov