SUPPORTING STATEMENT
VA FORMS 29-8700, 29-8700a, 29-8700b, 29-8700c, 29-8700d, 29-8700e
VA FORMS 29-8701, 29-8701a, 29-8701b, 29-8701c, 29-8701d, 29-8701e
VA FORMS 29-8485 & 29-8485a
APPLICATIONS FOR ORDINARY LIFE INSURANCE AGE 65 & 70
2900-0166
A. JUSTIFICATION
1. These forms are used by the policyholder to apply for replacement insurance for Modified Life Reduced at Age 65 and 70. The information is required by law, 38 U.S.C. Section 1904. The expiration date is being added to the forms.
2. The information collected on the forms are used by the Department of Veterans Affairs (VA) to initiate the granting of coverage for which applied.
3.VA Forms 29-8700 a-e and 29-8701 a-e are on the Xerox 9700. VA Forms 29-8485 and 29-8485a are available on the One-VA web site in a fillable electronic format. VBA is currently hosting this form on a secure server and does not currently have the technology in place to allow for the complete submission of this form. Validation edits are performed to assure data integrity. Efforts within VA are underway to provide a mechanism to allow the information to be submitted electronically with a recognized signature technology. There currently is no utility process in place that will allow the data submitted on the form to be incorporated with an existing centralized legacy database.
4. The information is not contained in any other VA records. Similar information is not available elsewhere.
5. The information does not involve any small businesses.
6. The forms are designed for use by the insurance activity to determine the insured's eligibility for the insurance. The collection is generally conducted only once.
7. There are no special circumstances requiring that the collection be conducted in a manner inconsistent with the guidelines in 5 CFR Section 1320.6.
8. The Department notice was published in the Federal Register on January 31, 2014, Volume 79, No. 21, Pages 5529-5530. The information does not involve obtaining information from any state or local Government. There is no person or organization other than VA that will collect the information which is submitted by the insured. No comments were received in response to this notice.
9. The information collected is supplied by the respondent. No remuneration is made.
10. The information collection conforms with the Privacy Act of 1974 and is subject to the conditions of disclosure contained therein. The records are maintained in the system identified as 36VA00, "Veterans and Armed Forces Personnel United States Government Life Insurance Records - VA" as contained in the Privacy Act Issuances, 1993 Compilation.
11. There are no questions of a sensitive nature.
12. Estimate of Information Collection Burden
a. Number of Respondents: 15,400
b. Frequency of Response: On Occasion
c. Annual Burden Hours: 1,284 Burden Hours
d. Estimated Completion Time: 5 Minutes (We estimate that it will take approximately 5 minutes to complete each of the following forms: VA Forms 29-8700, 29-8700a, 29-8700b, 29-8700c, 29-8700d, 29-8700e, 29-8701, 29-8701a, 29-8701b, 29-8701c, 29-8701d, 29-8701e, 29-8485 and 29-8485a. We arrived at this estimate by initiating a trial with a VA staff member unfamiliar with the form.)
e. According to the U.S. Bureau of Labor Statistics Average Hourly Earnings, the cost to the respondent is $24, making the total cost to the respondents an estimated $30,816. (1,284 burden hours X $24 per hour).
13. This submission does not involve any record keeping costs.
14. Cost to Government:
$13,845.00 Estimated mailing cost (15,400 X 2 minutes per
form X $15.51/hour (average salary for station
mail personnel) plus 15,400 forms X 38.2 cents
each (presort discount)).
$14,353.00 Estimated cost for collections (15,400 X 4 minutes
per form X $13.98/hour (average salary of station
collections personnel)).
$25,449.00 Estimated cost for processing (15,400 forms X
5 minutes per form X $19.83/hour (Average
salary for reviewers)).
$30.00 Estimated printing costs (1,000 X $30/1,000
forms).
$53,677.00 Total cost to the Government.
15. There have not been any program changes or adjustments. The expiration date is being added to the forms.
16. The information is collected for insurance purposes only and there are no plans for publication.
17. We are not seeking approval to omit the expiration date for OMB approval.
18. This submission does not contain any exceptions to the certification statement.
This collection of information does not employ statistical methods.
| File Type | application/msword |
| Author | VBA USER |
| Last Modified By | Bolyard, Dottie, VBAVACO |
| File Modified | 2014-03-27 |
| File Created | 2014-03-21 |