Application by Insured Terminally Ill Person for Accelerated Benefit (SGLV 8284)

ICR 202108-2900-015 · OMB 2900-0618 · Received in OIRA

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 2900-0618 can be found here:

2024-10-07 - Extension without change of a currently approved collection

Forms and Documents

Document	Type	Status	Availability
Form SGLV 8284 Application by Insured Terminally Ill Person for Accelerated Benefit (SGLV 8284)	Form	Modified	Missing upstream
2021-25258.pdf	Supplementary Document	Uploaded 2021-12-02	Repair queued
2021-23854.pdf	Supplementary Document	Uploaded 2021-11-03	Repair queued
SupportingStatement(2900-0618).docx	Supporting Statement A	Uploaded 2021-10-27	Repair queued
2021-18116.pdf	Supplementary Document	Uploaded 2021-10-27	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
28874	Application by Insured Terminally Ill Person for Accelerated Benefit (SGLV 8284)	Form	Modified

ICR Details

OMB Control No: 2900-0618	ICR Reference No: 202108-2900-015
Status: Received in OIRA	Previous ICR Reference No: 201802-2900-003
Agency/Subagency: VA	Agency Tracking No: VBA-INS-NK
Title: Application by Insured Terminally Ill Person for Accelerated Benefit (SGLV 8284)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 12/02/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	200	0
Time Burden (Hours)	40	0
Cost Burden (Dollars)	0	0

Abstract: The SGLV 8284 form is used by an insured who is terminally ill to request payment of a portion of the face value of the SGLI or VGLI as an Accelerated Benefit.

Authorizing Statute(s): US Code: 38 USC 1980 Name of Law: Option to Receive Accelerated Death Benefit
PL: Pub.L. 105 - 368 302 Name of Law: Veterans Programs Enhancement Act of 1998

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 18116	08/24/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 23854	11/02/2021
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Application by Insured Terminally Ill Person for Accelerated Benefit (SGLV 8284)	SGLV 8284	Servicemember's and Veterans Group Life Insurance Accelerated Benefits Option

ICR Summary of Burden

	Total Request	Change Due to Potential Violation of the PRA
Annual Number of Responses	200	200
Annual Time Burden (Hours)	40	40
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

Annual Cost to Federal Government: $2,294

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Maribel Aponte 202 266-4688 [email protected]

Common Form ICR: No