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Federal forms, ICRs, and supporting documents

Information Collection Request

APPLICATION FOR REINSTATEMENT (MEDICAL) - GOVERNMENT LIFE INSURANCE AND/OR TOTAL DISABILITY INCOME PROVISION

ICR 198608-2900-014 · OMB 2900-0011 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
174028 APPLICATION FOR REINSTATEMENT (MEDICAL) - GOVERNMENT LIFE INSURANCE AND/OR TOTAL DISABILITY INCOME PROVISION Form Migrated
ICR Details
2900-0011 198608-2900-014
Historical Active 198503-2900-006
VA
APPLICATION FOR REINSTATEMENT (MEDICAL) - GOVERNMENT LIFE INSURANCE AND/OR TOTAL DISABILITY INCOME PROVISION
No material or nonsubstantive change to a currently approved collection   No
Emergency 08/08/1986
Approved with change 08/08/1986
Retrieve Notice of Action (NOA) 08/08/1986
  Inventory as of this Action Requested Previously Approved
03/31/1988 03/31/1988 03/31/1988
750 0 1,500
938 0 1,877
0 0 0
THIS FORM IS USED BY VETERANS TO APPLY FOR REINSTATEMENT OF THEIR LAPSED GOVERNMENT LIFE INSURANCE AND/OR TOTAL DISABILITY INCOME PROVISION. THE DATA COLLECTED IS USED BY THE VA TO DETERMINE ELIGIBILITY FOR THE PURPOSE OF REINSTATEMENT. THE INFORMATION COLLECT IS REQUIRED BY LAW, 38 C.F.R. SECTIONS 6.80 AND 8.24.
None
None
No
1
IC Title Form No. Form Name
APPLICATION FOR REINSTATEMENT (MEDICAL) - GOVERNMENT LIFE INSURANCE AND/OR TOTAL DISABILITY INCOME PROVISION 29-352
  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 750 1,500 0 0 -750 0
Annual Time Burden (Hours) 938 1,877 0 0 -939 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$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.
08/08/1986