SUPPLEMENTAL DISABILITY REPORT

ICR 199210-2900-002

OMB: 2900-0129

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
147210 Migrated
ICR Details
2900-0129 199210-2900-002
Historical Active 199001-2900-007
VA
SUPPLEMENTAL DISABILITY REPORT
Revision of a currently approved collection   No
Regular
Approved without change 11/20/1992
Retrieve Notice of Action (NOA) 10/02/1992
  Inventory as of this Action Requested Previously Approved
11/30/1995 11/30/1995 10/31/1992
6,570 0 6,570
575 0 2,050
0 0 0

THIS FORM LETTER IS USED BY THE INSURED TO SUPPLY ADDITIONAL INFORMATI REQUIRED TO PROCESS A CLAIM FOR DISABILITY BENEFITS. THE FORM IS USED TO DETERMINE THE INDIVIDUAL'S ELIGIBILITY FOR DISABILITY BENEFITS (38 U.S.C. 712, 715, 742 AND 748).

None
None


No

1
IC Title Form No. Form Name
SUPPLEMENTAL DISABILITY REPORT 29-30A

  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 6,570 6,570 0 0 0 0
Annual Time Burden (Hours) 575 2,050 0 0 -1,475 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.
10/02/1992


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