Disability Benefits Questionnaire

ICR 200504-2900-001

OMB: 2900-0153

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
28378 Migrated
ICR Details
2900-0153 200504-2900-001
Historical Active 200202-2900-022
VA
Disability Benefits Questionnaire
Extension without change of a currently approved collection   No
Regular
Approved without change 06/17/2005
Retrieve Notice of Action (NOA) 04/04/2005
  Inventory as of this Action Requested Previously Approved
06/30/2008 06/30/2008 06/30/2005
60,000 0 60,000
15,000 0 15,000
0 0 0

These forms are used by policyholders to report conditions needed to continue benefits. The information requested is authorized by law 38 CFR Section 6.123, 6.123a and 8.42.

None
None


No

1
IC Title Form No. Form Name
Disability Benefits Questionnaire 29-8313, 29-8313-1

  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 60,000 60,000 0 0 0 0
Annual Time Burden (Hours) 15,000 15,000 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.
04/04/2005


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