Information Collection

Servicemembers' Group Life Insurance – Spouse Coverage (fsgli) Election And Certificate Form (sglv 8286a)

IC 262351 under ICR 202309-2900-004 · OMB 2900-0938.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SGLV 8286A SERVICEMEMBERS' GROUP LIFE INSURANCE – SPOUSE COVERAGE (FSGLI) ELECTION AND CERTIFICATE FORM (SGLV 8286A)	Form
SGLV 8286A SERVICEMEMBERS’ GROUP LIFE INSURANCE – SPOUSE COVERAGE ( SGLV 8286A.pdf www.benefits.va.gov/insurance/	Form
SGLV 8286A SERVICEMEMBERS’ GROUP LIFE INSURANCE – SPOUSE COVERAGE ( SGLV 8286A.pdf www.benefits.va.gov/insurance/	Form

IC Title:

SERVICEMEMBERS' GROUP LIFE INSURANCE â SPOUSE COVERAGE (FSGLI) ELECTION AND CERTIFICATE FORM (SGLV 8286A)

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	SGLV 8286A	SERVICEMEMBERSâ GROUP LIFE INSURANCE â SPOUSE COVERAGE (FSGLI) ELECTION AND CERTIFICATE FORM	SGLV 8286A.pdf	https://www.benefits.va.gov/insurance/	Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title: 36VA29, Veterans and Uniformed Services Personnel Programs of the U.S. Government Life Insurance - VA

FR Citation: 88 FR 26872

Number of Respondents: 1,600

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,600	1,600
Annual IC Time Burden (Hours)	267	267
Annual IC Cost Burden (Dollars)	6,816	6,816

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.