This request is
approved with the condition that the VA include a statement
informing the insurance applicant that they are not required to
fill in items 1,3 and 4 should the information be correct on the
reverse of the form.
Inventory as of this Action
Requested
Previously Approved
06/30/1984
06/30/1984
05/31/1981
1,000
0
1,000
83
0
83
0
0
0
APPLICATION IS NECESSARY FOR THE
ISSUANCE OF REPLACEMENT INSURANCE FOR MODIFIED LIFE REDUCED AT AGE
65. INFORMATION IS USED ISSUANCE OF REPLACEMENT ORDINARY LIFE
INSURANCE.
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.