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Federal forms, ICRs, and supporting documents

Information Collection Request

APPLICATION FOR EXCHANGE TO SPECIAL ENDOWMENT AT AGE 96 PLAN

ICR 198011-2900-094 · OMB 2900-0141 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
174358 APPLICATION FOR EXCHANGE TO SPECIAL ENDOWMENT AT AGE 96 PLAN Form Migrated
ICR Details
2900-0141 198011-2900-094
Historical Active 197603-2900-005
VA
APPLICATION FOR EXCHANGE TO SPECIAL ENDOWMENT AT AGE 96 PLAN
No material or nonsubstantive change to a currently approved collection   No
Emergency 11/06/1980
Approved with change 11/06/1980
Retrieve Notice of Action (NOA) 11/06/1980
  Inventory as of this Action Requested Previously Approved
04/30/1981 04/30/1981 04/30/1981
75 0 100
13 0 17
0 0 0
THE COMPLETED FORM IS REQUIRED BY LAW, 38 U.S.C. 742. THE INFORMATION COLLECTED IS USED TO PROCESS THE INSURED'S REQUEST TO EXCHANGE HIS/HER TERM POLICY.
None
None
No
1
IC Title Form No. Form Name
APPLICATION FOR EXCHANGE TO SPECIAL ENDOWMENT AT AGE 96 PLAN 29-358A
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 75 100 0 -25 0 0
Annual Time Burden (Hours) 13 17 0 -4 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/06/1980