Information Collection

Application for Veterans Affairs Life Insurance (VALife)

IC 251444 under ICR 202112-2900-001 · OMB 2900-0906.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0906 can be found here:

Documents and Forms

Document Name Document Type
Form 29-10277 Application for Veterans Affairs Life Insurance (VALI) Form
29-10277 Application for Veterans Affairs Life Insurance (VALI) VA Form 29-10277 (New OMB) 12-8-21.pdf www.va.gov/vaforms Form
29-10277 Application for Veterans Affairs Life Insurance (VALife) VA Form 29-10277 (New OMB) 12-8-21.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Veterans Affairs Life Insurance (VALife)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	29-10277	Application for Veterans Affairs Life Insurance (VALife)	VA Form 29-10277 (New OMB) 12-8-21.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25,000	25,000
Annual IC Time Burden (Hours)	8,333	8,333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.