Claim for One Sum Payment (Government Life Insurance), Claim for Monthly Payments (National Service Life Insurance), and Claim for Monthly Payments, U.S. Government Insurance

Claim for One Sum Payment (Government Life Insurance), Claim for Monthly Payments (National Service Life Insurance), and Claim for Monthly Payments, U.S. Government Insurance- VA Forms 29-4125 & 4125A

OMB: 2900-0060

IC ID: 28196

Information Collection (IC) Details

View Information Collection (IC)

Claim for One Sum Payment (Government Life Insurance), Claim for Monthly Payments (National Service Life Insurance), and Claim for Monthly Payments, U.S. Government Insurance 2900-0060
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form VA Form 29-4125 Claim for One Sum Payment (Government Life Insurance) 29-4125(2-22-16).pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 29-4125a Claim for Monthly Payments National Life Insurance 29-4125a(2-22-16).pdf www.va.gov/vaforms Yes No Fillable Printable

General Government Legislative Functions

 

120,100 0
   
Individuals or Households
 
   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 120,100 0 35,750 0 0 84,350
Annual IC Time Burden (Hours) 12,010 0 3,500 0 0 8,510
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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