OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

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

ICR 201006-2900-004 · OMB 2900-0066 · Historical Inactive

Forms and Documents
DocumentTypeStatusAvailability
Form VA Form Letter 29- Request for Employment Information in Connection with a Claim for Disability Benefits Form Modified Repair queued
2900-0066 justification.doc Supporting Statement A Uploaded 2010-09-21 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 201006-2900-004
Historical Inactive 200707-2900-030
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
Withdrawn and continue 12/05/2010
Retrieve Notice of Action (NOA) 09/24/2010
In accordance with 5 CFR 1320, the information collection request was withdrawn at the agency's request.
  Inventory as of this Action Requested Previously Approved
12/31/2010 36 Months From Approved 12/07/2010
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
  75 FR 121 06/24/2010
75 FR 168 08/31/2010
No
No
No
$20,524
No
No
No
No
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.
09/24/2010