OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Servicemembers' Group Life Insurance Traumatic Injury Protection Program Application for TSGLI Benefits

ICR 200903-2900-008 · OMB 2900-0671 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form SGLV 8600 Traumatic Injury Protection (TSGLI) Form Unchanged Repair queued
2900-0671 justification.DOC Supporting Statement A Uploaded 2009-05-11 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
44128 Traumatic Injury Protection (TSGLI) Form Unchanged
ICR Details
2900-0671 200903-2900-008
Historical Active 200810-2900-006
VA 2900-0671
Servicemembers' Group Life Insurance Traumatic Injury Protection Program Application for TSGLI Benefits
Extension without change of a currently approved collection   No
Regular
Approved without change 08/19/2009
Retrieve Notice of Action (NOA) 06/18/2009
  Inventory as of this Action Requested Previously Approved
08/31/2012 36 Months From Approved 09/30/2009
1,500 0 1,500
1,125 0 1,125
0 0 0
This form is designed for use by servicemembers who are insured under Servicemembers' Group Life Insurance (SGLI) and suffer a loss from a traumatic injury. This form is replacing GL.2005.261
PL: Pub.L. 109 - 13 1032(d) Name of Law: Emergency Supplemental Appropriations Act for Defense, GWT, Tsunamie Relief, 2005
  
None
2900-AN00 Final or interim final rulemaking 74 FR 106 06/04/2009
  74 FR 59 03/30/2009
74 FR 112 06/12/2009
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 1,500 1,500 0 0 0 0
Annual Time Burden (Hours) 1,125 1,125 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
No
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.
06/18/2009