CLAIM FOR DISABILITY INSURANCE BENEFITS

ICR 198608-2900-015

OMB: 2900-0016

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
174046 Migrated
ICR Details
2900-0016 198608-2900-015
Historical Active 198312-2900-021
VA
CLAIM FOR DISABILITY INSURANCE BENEFITS
No material or nonsubstantive change to a currently approved collection   No
Emergency 08/08/1986
Approved with change 08/08/1986
Retrieve Notice of Action (NOA) 08/08/1986
  Inventory as of this Action Requested Previously Approved
12/31/1986 12/31/1986 12/31/1986
13,250 0 19,440
26,500 0 38,880
0 0 0

THIS FORM IS USED BY AN NSLI OR USGLI POLICYHOLDER TO CLAIM DISABILITY INSURANCE BENEFITS.

None
None


No

1
IC Title Form No. Form Name
CLAIM FOR DISABILITY INSURANCE BENEFITS 29-357

  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 13,250 19,440 0 0 -6,190 0
Annual Time Burden (Hours) 26,500 38,880 0 0 -12,380 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.
08/08/1986


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