Information Collection

Application for Reinstatement and or Total Disability Income Provision

IC 28089 under ICR 201303-2900-016 · OMB 2900-0011.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0011 can be found here:

Documents and Forms

Document Name Document Type
Form VA Form 29-353 Application for Reinstatement and or Total Disability Income Provision Form
VA Form 29-353 Application for Reinstatement (Non Medical - Comparative VA Form 29-353.pdf www.va.gov/vaforms Form
VA Form 29-352 Application for Reinstatement (Insurance Lapsed more tha VA Form 29-352.pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Reinstatement and or Total Disability Income Provision	Agency IC Tracking Number:	2900-0011 VBA-INS-DB

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 8.22 38 CFR 6.79 38 CFR 8.23 38 CFR 8.8

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 29-353	Application for Reinstatement (Non Medical - Comparative Health Statement)	VA Form 29-353.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 29-352	Application for Reinstatement (Insurance Lapsed more than 6 months) Government Life Insurance and/or Total Disability Income Provision	VA Form 29-352.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	1,125	1,125
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.