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VA MATIC Enrollment/Change
VA MATIC Enrollment/Change (VA Form 29-0165)
OMB: 2900-0525
IC ID: 28715
OMB.report
VA
OMB 2900-0525
ICR 202211-2900-006
IC 28715
( )
Documents and Forms
Document Name
Document Type
Form VA Form 29-0165
VA MATIC Enrollment/Change
Form
VA Form 29-0165 VA MATIC Enrollment/Change
29-0165(11-9-22).pdf
www.va.gov/vaforms
Form
VA Form 29-0165 VA MATIC Enrollment/Change
29-0165(11-9-22).pdf
www.va.gov/vaforms
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
VA MATIC Enrollment/Change
Agency IC Tracking Number:
2900-0525
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
VA Form 29-0165
VA MATIC Enrollment/Change
29-0165(11-9-22).pdf
www.va.gov/vaforms
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Legislative Functions
Privacy Act System of Records
Title:
36VA29, Veterans and Uniformed Services Personnel Programs of U.S. Government Life Insurance -VA
FR Citation:
88 FR 1032
Number of Respondents:
5,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
5,000
0
0
0
0
5,000
Annual IC Time Burden (Hours)
417
0
-833
0
0
1,250
Annual IC Cost Burden (Dollars)
0
0
0
0
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.
