Application for Supplemental Service Disabled Veterans (RH) Life Insurance

ICR 199508-2900-011

OMB: 2900-0539

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
2900-0539 199508-2900-011
Historical Inactive 199506-2900-005
VA
Application for Supplemental Service Disabled Veterans (RH) Life Insurance
Revision of a currently approved collection   No
Regular
Withdrawn and continue 09/20/1995
Retrieve Notice of Action (NOA) 08/15/1995
Withdrawn pursuant to Agency's request.
  Inventory as of this Action Requested Previously Approved
10/31/1998 09/30/1998 10/31/1998
10,000 0 0
3,333 0 3,333
0 0 0

This form is used by veterans to apply for Supplemental Service-Disabled Veterans Insurance. The dates collected are used to determine eligibility for insurance. The information collected is required by law (38 USC 1922).

None
None


No

1
IC Title Form No. Form Name
Application for Supplemental Service Disabled Veterans (RH) Life Insurance 29-0190

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.
08/15/1995


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