OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Request for Employment Information in Connection with a Claim for Disability Benefits

ICR 200707-2900-030 · OMB 2900-0066 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form VA Form Letter 29- Request for Employment Information in Connection with a Claim for Disability Benefits Form Modified Available
459SUPP[1].DOC Supporting Statement A Uploaded 2007-11-05 Available
IC Document Collections
IC IDCollectionTypeStatusForm
28208 Request for Employment Information in Connection with a Claim for Disability Benefits Form Modified
ICR Details
2900-0066 200707-2900-030
Historical Active 200408-2900-004
VA 2900-0066
Request for Employment Information in Connection with a Claim for Disability Benefits
Extension without change of a currently approved collection   No
Regular
Approved without change 12/05/2007
Retrieve Notice of Action (NOA) 11/02/2007
  Inventory as of this Action Requested Previously Approved
12/31/2010 36 Months From Approved 12/31/2007
5,167 0 5,167
862 0 862
0 0 0
The form is designed for use by VA to determine insured's eligibility for insurance benefits. The information is authorized by law, Title 38, USC Sections 1912, 1915, 1942 and 1948.
US Code: 38 USC Section 1912 Name of Law: Total disability waiver
   US Code: 38 USC Section 1915 Name of Law: Total disability income provision
   US Code: 38 USC Section 1942 Name of Law: Plans of insurance
   US Code: 38 USC Section 1948 Name of Law: Total disability provision
  
None
Not associated with rulemaking
  72 FR 145 07/30/2007
72 FR 196 10/11/2007
No
  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 5,167 5,167 0 0 0 0
Annual Time Burden (Hours) 862 862 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$12,930
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Denise McLamb 202-565-8374 [email protected]
  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.
11/02/2007