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Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Supplemental Service-Disabled Veterans (RH) Life Insurance

ICR 199506-2900-005 · OMB 2900-0539 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
148390 Application for Supplemental Service-Disabled Veterans (RH) Life Insurance Form Migrated
ICR Details
2900-0539 199506-2900-005
Historical Active 199212-2900-005
VA
Application for Supplemental Service-Disabled Veterans (RH) Life Insurance
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 08/17/1995
Retrieve Notice of Action (NOA) 06/07/1995
  Inventory as of this Action Requested Previously Approved
10/31/1998 10/31/1998
10,000 0 0
3,333 0 0
0 0 0
This form is used by veterans to apply for Supplemental Service-Disabled Veterans Insurance. The dates collected are used to determine eligibility for insurance. The information collected is required by law (38 U.S.C. 1922).
None
None
No
1
IC Title Form No. Form Name
Application for Supplemental Service-Disabled Veterans (RH) Life Insurance VA-29-0188
  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 10,000 0 0 10,000 0 0
Annual Time Burden (Hours) 3,333 0 0 3,333 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
06/07/1995