Claim for One Sum Payment - Gov. Life Ins. (VAF 29-4125), Claim for Monthly Payments - National Service Life Ins. (VAF 29-4125a), Claim for One Sum Payment - Gov. Life Ins. (VAF 29-4125e (DocuSign)

OMB 2900-0060

The VA Forms 29-4125 and 29-4125A are used by beneficiaries to request the proceeds from Government Life Insurance policies. The information is required by law, 38 U.S.C. 1917 and 1952.

The latest form for Claim for One Sum Payment - Gov. Life Ins. (VAF 29-4125), Claim for Monthly Payments - National Service Life Ins. (VAF 29-4125a), Claim for One Sum Payment - Gov. Life Ins. (VAF 29-4125e (DocuSign) expires 2022-10-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
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
Published 30-Day FRN.pdf Supplementary Document
Supporting Statement - 2900-0060 (11-15-24).docx Supporting Statement A
2024-20356.pdf Supplementary Document
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

All Historical Document Collections

202408-2900-009	Revision of a currently approved collection	2024-11-15
202110-2900-003 Approved without change	Extension without change of a currently approved collection	2022-01-18
201901-2900-003 Approved with change	Revision of a currently approved collection	2019-06-12
201602-2900-027 Approved with change	Revision of a currently approved collection	2016-07-26
201305-2900-017 Approved without change	Extension without change of a currently approved collection	2013-09-19
201009-2900-002 Approved without change	Extension without change of a currently approved collection	2010-12-01
200805-2900-009 Approved without change	Extension without change of a currently approved collection	2008-09-02
200507-2900-012 Approved without change	Extension without change of a currently approved collection	2005-07-19
200208-2900-013 Approved without change	No material or nonsubstantive change to a currently approved collection	2002-08-29
200208-2900-005 Approved with change	Extension without change of a currently approved collection	2002-08-08
200207-2900-002 Approved without change	Reinstatement without change of a previously approved collection	2002-07-03
200202-2900-020 Withdrawn and continue	Extension without change of a currently approved collection	2002-02-27
200201-2900-021 Withdrawn and continue	Extension without change of a currently approved collection	2002-01-18
199811-2900-006 Approved without change	Reinstatement with change of a previously approved collection	1998-11-12
199503-2900-012 Approved without change	Reinstatement with change of a previously approved collection	1995-03-29
199107-2900-014 Approved without change	Revision of a currently approved collection	1991-07-30
198805-2900-007 Approved without change	Revision of a currently approved collection	1988-05-19
198703-2900-001 Approved without change	Revision of a currently approved collection	1987-03-10
198608-2900-025 Approved with change	No material or nonsubstantive change to a currently approved collection	1986-08-08
198312-2900-025 Approved without change	Revision of a currently approved collection	1983-12-28
198209-2900-016 Approved with change	No material or nonsubstantive change to a currently approved collection	1982-09-07
198101-2900-015 Approved with change	No material or nonsubstantive change to a currently approved collection	1981-01-22
197908-2900-018 Approved with change	No material or nonsubstantive change to a currently approved collection	1979-08-01
197901-2900-014 Approved with change	No material or nonsubstantive change to a currently approved collection	1979-01-16
197901-2900-010 Approved without change	Extension without change of a currently approved collection	1979-01-16
197402-2900-001 Approved without change	New collection (Request for a new OMB Control Number)	1974-02-19