Claim for Life Insurance Proceeds (NSLI & USGLI)

ICR 200208-2900-005

OMB: 2900-0060

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
28195 Migrated
ICR Details
2900-0060 200208-2900-005
Historical Active 200207-2900-002
VA
Claim for Life Insurance Proceeds (NSLI & USGLI)
Extension without change of a currently approved collection   No
Regular
Approved with change 08/23/2002
Retrieve Notice of Action (NOA) 08/08/2002
Approved consistent with agreement between OMB and VA on 8/6/02. This approval is for VA forms 29-4125, 29-4125a and 29-4125k. VA has discontinued forms 29-4125b and 29-764.
  Inventory as of this Action Requested Previously Approved
08/31/2005 08/31/2005 09/30/2002
85,850 0 85,850
8,938 0 8,938
0 0 0

These forms are used by beneficiaries for the proceeds of insurance. The information is required by law, 38 USC 1917 and 1952.

None
None


No

1
IC Title Form No. Form Name
Claim for Life Insurance Proceeds (NSLI & USGLI) 29-4125, 29-4125A, 29-4125B, 29-4125K, 29-764

  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 85,850 85,850 0 0 0 0
Annual Time Burden (Hours) 8,938 8,938 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.
08/08/2002


© 2024 OMB.report | Privacy Policy