Information Collection

Matured Endowment Notification (29-5767)

IC 28391 under ICR 201708-2900-023 · OMB 2900-0159.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 29-5767 Matured Endowment Notification (29-5767)	Form
VA Form 29-5767 Application for Payment of Matured Endowment 29-5767(8-30-17).pdf	Form

IC Title:

Agency IC Tracking Number:

2900-0159

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 8.92 38 CFR 6.69

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	VA Form 29-5767	Application for Payment of Matured Endowment	29-5767(8-30-17).pdf		Yes	No	Paper Only

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title: 36VA00_Veterans and Armed Forces Personnel United States Government Life Insurance Records - VA

FR Citation: 75 FR 65405

Number of Respondents: 8,600

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	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	8,600	8,600
Annual IC Time Burden (Hours)	2,867	2,867
Annual IC Cost Burden (Dollars)	4,214	4,214

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.