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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	29-10277	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 %

table that charts list of burden
	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

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.