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

OMB 2900-0618

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.

The latest form for Application by Insured Terminally Ill Person for Accelerated Benefit (Forms SGLV 8284 & SGLV 8284a) expires 2021-09-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form SGLV 8284A Application by Insured Terminally Ill Person for Accelerated Benefit (SGLV 8284) Form
Supporting Statement(2900-0618) (1).docx Supporting Statement A
2024-23059.pdf Supplementary Document
2024-17063.pdf Supplementary Document
Application by Insured Terminally Ill Person for Accelerated Benefit (SGLV 8284) Form

All Historical Document Collections

202407-2900-004	Extension without change of a currently approved collection	2024-10-07
202108-2900-015 Approved without change	Reinstatement with change of a previously approved collection	2021-12-02
201802-2900-003 Approved with change	Reinstatement without change of a previously approved collection	2018-06-22
201403-2900-005 Approved without change	Revision of a currently approved collection	2014-10-29
201106-2900-003 Approved without change	Extension without change of a currently approved collection	2011-10-06
200805-2900-010 Approved without change	Extension without change of a currently approved collection	2008-09-03
200508-2900-004 Approved without change	Extension without change of a currently approved collection	2005-08-09
200207-2900-006 Approved without change	New collection (Request for a new OMB Control Number)	2002-07-12