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Application for Conversion (Government Life Insurance)
Application for Conversion (Government Life Insurance)
OMB: 2900-0149
IC ID: 28374
OMB.report
VA
OMB 2900-0149
ICR 200712-2900-022
IC 28374
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0149 can be found here:
2024-06-20 - Extension without change of a currently approved collection
2021-06-28 - Reinstatement with change of a previously approved collection
Documents and Forms
Document Name
Document Type
Form VA Form 29-0152
Application for Conversion (Government Life Insurance)
Form
VA Form 29-0152 Application for Conversion
29-0152.pdf
www.va.gov/vaforms
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Application for Conversion (Government Life Insurance)
Agency IC Tracking Number:
2900-0149
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
VA Form 29-0152
Application for Conversion
29-0152.pdf
www.va.gov/vaforms
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Legislative Functions
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4,500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
4,500
0
0
0
0
4,500
Annual IC Time Burden (Hours)
1,125
0
0
0
0
1,125
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.