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

ICR 202407-2900-004

OMB: 2900-0618

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2024-10-07
Supplementary Document
2024-10-07
Supplementary Document
2024-08-02
IC Document Collections
ICR Details
2900-0618 202407-2900-004
Received in OIRA 202108-2900-015
VA VBA-INS-NK
Application by Insured Terminally Ill Person for Accelerated Benefit (Forms SGLV 8284 & SGLV 8284a)
Extension without change of a currently approved collection   No
Regular 10/07/2024
  Requested Previously Approved
36 Months From Approved 01/31/2025
200 200
40 40
0 0

The SGLV 8284 and SGLV 8284a forms are used by an insured who is terminally ill to request payment of a portion of the face value of the Servicemembers' Group Life Insurance (SGLI) or Veterans Group Life Insurance (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

  89 FR 63254 08/02/2024
89 FR 81153 10/07/2024
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 200 200 0 0 0 0
Annual Time Burden (Hours) 40 40 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$2,546
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.
10/07/2024


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