OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Claim for One Sum Payment (Government Life Insurance), Claim for Monthly Payments (National Service Life Insurance), and Claim for Monthly Payments, U.S. Government Insurance

IC 28196 under ICR 202408-2900-009 · OMB 2900-0060.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form VA Form 29-4125
Claim for One Sum Payment (Government Life Insurance), Claim for Monthly Payments (National Service Life Insurance), and Claim for Monthly Payments, U.S. Government Insurance		 Form
Form VA Form 29-4125
Claim for One Sum Payment (Government Life Insurance) Claim for One Sum Payment (Government Life Insurance), Claim for Monthly Payments (National Service Life Insurance), and Claim for Monthly Payments, U.S. Government Insurance		 Form
Form VA Form 29-4125a
Claim for Monthly Payments National Service Life Insurance Claim for One Sum Payment (Government Life Insurance), Claim for Monthly Payments (National Service Life Insurance), and Claim for Monthly Payments, U.S. Government Insurance		 Form
Form VA Form 29-4125e (
Claim for One Sum Payment (Government Life Insurance) Claim for One Sum Payment (Government Life Insurance), Claim for Monthly Payments (National Service Life Insurance), and Claim for Monthly Payments, U.S. Government Insurance		 Form
VA Form 29-4125 Claim for One Sum Payment (Government Life Insurance)
29-4125(10-10-24).pdf
www.va.gov/vaforms 		Form
VA Form 29-4125 Claim for One Sum Payment (Government Life Insurance)
29-4125(10-10-24).pdf
www.va.gov/vaforms 		Form
VA Form 29-4125a Claim for Monthly Payments National Service Life Insuran
29-4125a(10-10-24).pdf
www.va.gov/vaforms 		Form
VA Form 29-4125a Claim for Monthly Payments National Service Life Insuran
29-4125a(10-10-24).pdf
www.va.gov/vaforms 		Form
VA Form 29-4125e ( Claim for One Sum Payment (Government Life Insurance)
29-4125e (DocuSign) (10-10-24).pdf
www.va.gov/insurance 		Form
VA Form 29-4125e ( Claim for One Sum Payment (Government Life Insurance)
29-4125e (DocuSign) (10-10-24).pdf
www.va.gov/insurance 		Form

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 VA Form 29-4125 www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 29-4125a www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 29-4125e (DocuSign) www.va.gov/insurance Yes Yes Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 120,100 0 0 0 0 120,100
Annual IC Time Burden (Hours) 12,010 0 0 0 0 12,010
Annual IC Cost Burden (Dollars) 0 0 0 0 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.
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