Claim for One Sum Payment (Government Life Insurance), Claim for Monthly Payments (National Service Life Insurance), and Claim for Monthly Payments, U.S. Government Insurance

Claim for One Sum Payment - Gov. Life Ins. (VAF 29-4125), Claim for Monthly Payments - National Service Life Ins. (VAF 29-4125a), Claim for One Sum Payment - Gov. Life Ins. (VAF 29-4125e (DocuSign)

Documents and Forms

Document Name Document Type
Form VA Form 29-4125 Claim for One Sum Payment (Government Life Insurance), Claim for Monthly Payments (National Service Life Insurance), and Claim for Monthly Payments, U.S. Government Insurance Form
VA Form 29-4125 Claim for One Sum Payment (Government Life Insurance) 29-4125(10-10-24).pdf www.va.gov/vaforms Form
VA Form 29-4125a Claim for Monthly Payments National Service Life Insuran 29-4125a(10-10-24).pdf www.va.gov/vaforms Form
VA Form 29-4125e ( Claim for One Sum Payment (Government Life Insurance) 29-4125e (DocuSign) (10-10-24).pdf www.va.gov/insurance Form

Information Collection (IC) Details

IC Title:	Claim for One Sum Payment (Government Life Insurance), Claim for Monthly Payments (National Service Life Insurance), and Claim for Monthly Payments, U.S. Government Insurance	Agency IC Tracking Number:	2900-0060

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 29-4125	Claim for One Sum Payment (Government Life Insurance)	29-4125(10-10-24).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 29-4125a	Claim for Monthly Payments National Service Life Insurance	29-4125a(10-10-24).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 29-4125e (DocuSign)	Claim for One Sum Payment (Government Life Insurance)	29-4125e (DocuSign) (10-10-24).pdf	www.va.gov/insurance	Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: 36VA29, Veterans and Uniformed Services Personnel Program of U.S. Government Life Insurance - VA	FR Citation: 89 FR 73508

Number of Respondents: 120,100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	120,100	120,100
Annual IC Time Burden (Hours)	12,010	12,010
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.