Form VA Form 29-888 VA Form 29-888 Insurance Deduction Authorization

OMB Control No. 2900-0024
Respondent Burden: 10 Mins.

INSURANCE DEDUCTION AUTHORIZATION
(FOR DEDUCTION FROM BENEFIT PAYMENTS)
PRIVACY ACT INFORMATION: No insurance deduction may be made unless a completed authorization has been received (38 CFR 8.8). The information requested
is required to obtain or retain benefits and will be used by VA employees and your authorized representatives in the maintenance of Government insurance programs.
Responses may be disclosed outside VA only if the disclosure is authorized under the Privacy Act, including the routine uses identified in the VA system of records,
36VA00, Veterans and Armed Forces Personnel U.S. Government Life Insurance Records - VA, published in the Federal Register.
RESPONDENT BURDEN: VA may not conduct or sponsor, and respondent is not required to respond to this collection of information unless it displays a valid OMB
Control Number. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. If you have
comments regarding this burden estimate or any other aspect of this collection of information, call 1-800-827-1000 for mailing information on where to send your
comments.
1. FIRST, MIDDLE, LAST NAME OF INSURED (Type or print)

2. INSURANCE FILE NO. (Include letter prefix)

3. NUMBER AND STREET OR RURAL ROUTE (Type or print)

4. VA CLAIM FILE NUMBER

5. CITY OR P. O., STATE AND ZIP CODE (Type or print)

6. TOTAL MONTHLY BENEFITS AWARDED (Before deductions)

7. ACTION REQUESTED

START
INCREASE

8. PURPOSE AND AMOUNT OF DEDUCTIONS TO BE MADE
DECREASE
DISCONTINUE

PREMIUM
LOAN
LEIN

$
$
$

AUTHORIZATION: The Department of Veterans Affairs is authorized: (1) to deduct each month from benefits payable to me the sum indicated in Item 6 to be used in
payment of premiums, repayment of Loans and/or Liens as shown above, and (2) TO ADJUST THE AMOUNT REQUIRED within the limits of benefits payable, to
pay premiums on my Government Life Insurance.
9. SIGNATURE OF INSURED

VA FORM
FEB 2002

29-888

10. DATE

SUPERSEDES VA FORM 29-888, DEC 1990,
WHICH WILL NOT BE USED.

IMPORTANT INFORMATION AND INSTRUCTIONS
Deductions from benefit payments are established to pay premiums on a one month in advance basis; i.e., a premium
deduction made from a January benefit payment will pay a premium due in February, a February deduction will pay a
March premium, and so forth. THEREFORE:
TO PREVENT LAPSE OF YOUR INSURANCE, CONTINUE TO PAY PREMIUMS UNTIL,
YOU HAVE BEEN NOTIFIED THAT THE AUTHORIZATION HAS BEEN ACCEPTED AND
THAT THE DEDUCTIONS FROM BENEFIT PAYMENTS ARE BEING MADE. ANY
OVERPAYMENT OF PREMIUMS WILL BE REFUNDED TO YOU.
Your authorization will remain in effect as long as your monthly benefit payment is enough to pay the monthly premium,
and/or loan, and/or lien payment. If you become entitled to a waiver of premiums under the disability provisions of your
policy, VA will stop the deductions for premium payments. They will be resumed after the waiver ends unless you have
canceled the authorization.
Monthly loan and/or lien payments should be authorized for $5.00 or more. Such payments will continue to be deducted
until your loan and/or lien is paid in full or you ask us to stop the deduction.
When completed and signed by you, send this authorization to the office where your insurance records are maintained.
The address of the Department of Veterans Affairs office that maintain these records is:
Department of Veterans Affairs
Regional Office and Insurance Center
P. O. Box 42954
Philadelphia, PA 19101