Approved consistent with revised form submitted to OMB by VA and included in the public docket on 5/3/2012.
Inventory as of this Action
Requested
Previously Approved
06/30/2015
36 Months From Approved
06/30/2012
8,100
0
8,100
14,175
0
14,175
0
0
0
This form is designed for use by the insurance activity to determine the insured's eligibility for disability insurance benefits. The information is authorized by law, USC Sections 1912, 1915, 1942, 1948.
US Code:
38 USC 1948
Name of Law: Total Disability Provision
US Code:
38 USC 1915
Name of Law: Total Disability Income Provision
US Code:
38 USC 1942
Name of Law: Plans of Insurance
US Code:
38 USC 1912
Name of Law: Total Disability Waiver
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.
Form 29-357 Claim for Disability Insurance Benefits, Government Life Insurance
VBA-29-357-ARE.pdf
2900-0016 justification.docx
Claim for Disability Insurance Benefits, Government Life Insurance