Application by Insured Terminally Ill Person for Accelerated Benefit (SGLV 8284)

ICR 202108-2900-015

OMB: 2900-0618

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2021-12-02
Supplementary Document
2021-11-03
Supporting Statement A
2021-10-27
Supplementary Document
2021-10-27
IC Document Collections
ICR Details
2900-0618 202108-2900-015
Received in OIRA 201802-2900-003
VA VBA-INS-NK
Application by Insured Terminally Ill Person for Accelerated Benefit (SGLV 8284)
Reinstatement with change of a previously approved collection   No
Regular 12/02/2021
  Requested Previously Approved
36 Months From Approved
200 0
40 0
0 0

The SGLV 8284 form is used by an insured who is terminally ill to request payment of a portion of the face value of the SGLI or VGLI as an Accelerated Benefit.

US Code: 38 USC 1980 Name of Law: Option to Receive Accelerated Death Benefit
   PL: Pub.L. 105 - 368 302 Name of Law: Veterans Programs Enhancement Act of 1998
  
None

Not associated with rulemaking

  86 FR 18116 08/24/2021
86 FR 23854 11/02/2021
No

  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 200 0 0 0 0 200
Annual Time Burden (Hours) 40 0 0 0 0 40
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$2,294
No
    Yes
    Yes
No
No
No
No
Maribel Aponte 202 266-4688 maribel.aponte@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.
12/02/2021


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