Information Collection

Notice - Payment Not Applied (29-4499a)

IC 28364 under ICR 201307-2900-003 · OMB 2900-0139.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 29-4499A Notice - Payment Not Applied Notice - Payment Not Applied (29-4499a)	Form
29-4499A Notice - Payment Not Applied 29-4499a.pdf www.va.gov/vaforms/	Form

IC Title:

Agency IC Tracking Number:

2900-0139 VBA-INS-DB

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 8.23

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	29-4499A			http://www.va.gov/vaforms/	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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