Information Collection Request
Authorization to Disclose Information to a Third Party (Insurance) (VA Forms 29-0975 & 29-0975e)
ICR 202401-2900-003 · OMB 2900-0856 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form VA Form 29-0975 AUTHORIZATION TO DISCLOSE PERSONAL INFORMATION TO A THIRD PARTY (INSURANCE) |
Form | Modified | Repair queued |
 SupportState(2900-0856).docx |
Supporting Statement A | Uploaded 2024-03-15 | Repair queued |
 2024-05553.pdf |
Supplementary Document | Uploaded 2024-03-15 | Missing upstream |
| 2024-00494.pdf |
Supplementary Document | Uploaded 2024-01-24 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 220731 |  AUTHORIZATION TO DISCLOSE PERSONAL INFORMATION TO A THIRD PARTY (INSURANCE) |
Form | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | VA |
| OMB Control No | 2900-0856 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 202206-2900-018 |
| Agency Tracking No | VBA-INS-NK |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |