Information Collection

VA MATIC Enrollment/Change

IC 28715 under ICR 202509-2900-002 · OMB 2900-0525.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 29-0165 PRE-AUTHORIZED COLLECTIONS (PAC)ENROLLMENT/CHANGE VA MATIC Enrollment/Change	Form
29-0165 PRE-AUTHORIZED COLLECTIONS (PAC)ENROLLMENT/CHANGE VBA-29-0165-ARE 2-2-26.pdf www.va.gov/forms/	Form

IC Title:

Agency IC Tracking Number:

2900-0525

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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	29-0165			https://www.va.gov/forms/	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 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 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	417	417
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.

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