Application for Supplemental Service Disabled Veterans Insurance

ICR 200107-2900-014

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 200107-2900-014
Historical Active 199808-2900-005
VA
Application for Supplemental Service Disabled Veterans Insurance
Extension without change of a currently approved collection   No
Regular
Approved without change 09/17/2001
Retrieve Notice of Action (NOA) 07/25/2001
  Inventory as of this Action Requested Previously Approved
11/30/2004 11/30/2004 10/31/2001
10,000 0 10,000
3,333 0 3,333
0 0 0

These forms are used to apply for Supplemental Service Disabled 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 Insurance 29-0188, 29-0189, 29-0190

  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 10,000 10,000 0 0 0 0
Annual Time Burden (Hours) 3,333 3,333 0 0 0 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.
07/25/2001


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