OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Request for Supplemental Information on Medical and Nonmedical Applications (FL 29-615)

ICR 201312-2900-004 · OMB 2900-0131 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form VA Form Letter 29- Request for Supplemental Information on Medical and Nonmedical Applications (FL 29-615) Form Modified Repair queued
30-Day FRN (2900-0131).pdf Supplementary Document Uploaded 2014-07-22 Repair queued
60-day FRN(2900-0131).pdf Supplementary Document Uploaded 2014-03-17 Available
OMBFL29-615(3-20-14).doc Supporting Statement A Uploaded 2014-03-20 Available
IC Document Collections
IC IDCollectionTypeStatusForm
28350 Request for Supplemental Information on Medical and Nonmedical Applications (FL 29-615) Form Modified
ICR Details
2900-0131 201312-2900-004
Historical Active 201104-2900-008
VA 2900-0131 VBA-INS-DB
Request for Supplemental Information on Medical and Nonmedical Applications (FL 29-615)
Revision of a currently approved collection   No
Regular
Approved without change 09/15/2014
Retrieve Notice of Action (NOA) 07/28/2014
  Inventory as of this Action Requested Previously Approved
09/30/2017 36 Months From Approved 09/30/2014
9,000 0 9,000
3,000 0 3,000
0 0 0
This form letter is used to apply for reinstatement or change of plan on Government Life Insurance.
None
None
Not associated with rulemaking
  78 FR 250 12/30/2013
79 FR 115 06/16/2014
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 9,000 9,000 0 0 0 0
Annual Time Burden (Hours) 3,000 3,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$31,622
No
No
No
No
No
Uncollected
Crystal Rennie 202 632-7492 [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.
07/28/2014