CLAIM FOR MONTHLY PAYMENTS OF NATIONAL SERVICE LIFE INSURANCE

ICR 198608-2900-057

OMB: 2900-0223

Federal Form Document

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ICR Details
2900-0223 198608-2900-057
Historical Active 198410-2900-016
VA
CLAIM FOR MONTHLY PAYMENTS OF NATIONAL SERVICE LIFE INSURANCE
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
09/30/1987 09/30/1987 09/30/1987
2,700 0 1,453
675 0 363
0 0 0

THIS FORM IS USED BY A BENEFICIARY WHEN APPLYING FOR THE PROCEEDS OF A NATIONAL SERVICE LIFE INSURANCE POLICY.

None
None


No

1
IC Title Form No. Form Name
CLAIM FOR MONTHLY PAYMENTS OF NATIONAL SERVICE LIFE INSURANCE 29-4125A

  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 2,700 1,453 0 0 1,247 0
Annual Time Burden (Hours) 675 363 0 0 312 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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