APPLICATION FOR TOTAL DISABILITY INCOME PROVISION (MEDICAL)

ICR 198604-2900-008

OMB: 2900-0015

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
2900-0015 198604-2900-008
Historical Active 198305-2900-005
VA
APPLICATION FOR TOTAL DISABILITY INCOME PROVISION (MEDICAL)
Revision of a currently approved collection   No
Regular
Approved without change 06/23/1986
Retrieve Notice of Action (NOA) 04/21/1986
  Inventory as of this Action Requested Previously Approved
06/30/1989 06/30/1989 05/31/1986
60 0 91
90 0 137
0 0 0

THIS APPLICATION IS USED BY APPLICANTS TO ESTABLISH ELIGIBILITY FOR TH PROVISION. THE COMPLETED APPLICATION IS REQUIRED BY THE VETERANS ADMINISTRATION TO DETERMINE THE INSURED'S ELIGIBILITY FOR THE PROVISIO 38 U.S.C., SECTIONS 715 AND 748.

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR TOTAL DISABILITY INCOME PROVISION (MEDICAL) VA29-1606

  Total Approved 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 60 91 0 0 -31 0
Annual Time Burden (Hours) 90 137 0 0 -47 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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.
04/21/1986


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