Federal Register: July 28, 2005 (Volume 70, Number 144)
DOCID: FR Doc E5-4008
DEPARTMENT OF VETERANS AFFAIRS
Veterans Affairs Department
OMB ID: [OMB Control No. 2900-0060]
DOCUMENT ACTION: Notice.
Agency Information Collection Activities Under OMB Review
DATES: Comments must be submitted on or before August 29, 2005.
In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 35013521) this notice announces that the Veterans Benefits Administration (VBA), Department of Veterans Affairs, has submitted the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden; it includes the actual data collection instrument.
Agency information collection activities; proposals, submissions, and approvals,
a. Claim for One Sum Payment (Government Life Insurance), VA Form 294125.
b. Claim for Monthly Payments (National Service Life Insurance), VA Form 294125a.
c. Claim for Monthly Payments (United States Government Life Insurance, (USGLI)), VA Form 294125k.
OMB Control Number: 29000060.
Type of Review: Extension of a currently approved collection.
Abstract: Beneficiaries of deceased veterans must complete VA Form 294125 to apply for proceeds of the veteran's Government Insurance policies. If the beneficiary desires monthly installment in lieu of one lump payment he or she must complete VA Forms 294125a and 294125k. VA uses the information to determine the claimant's eligibility for payment of insurance proceeds and to process monthly installment payments.
An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The Federal Register notice with a 60day comment period soliciting comments on this collection of information was published on March 28, 2005 at pages 1568815689.
Affected Public: Individuals or households.
Estimated Annual Burden: 8,787 hours.
a. VA Form 2941258,200 hours.
b. VA Form 294125a462 hours.
c. VA Form 4125k125 hours.
Estimated Average Burden Per Respondent:
a. VA Form 2941256 minutes.
b. VA Form 294125a15 minutes.
c. VA Form 4125k15 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents: 84,350.
a. VA Form 29412582,000
b. VA Form 294125a1,850
c. VA Form 4125k500
Dated: July 19, 2005.
By direction of the Secretary.
Program Analyst, Records Management Service.
[FR Doc. E54008 Filed 72705; 8:45 am]
BILLING CODE 832001P
FOR FURTHER INFORMATION CONTACT
Denise McLamb, Records Management Service (005E3), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 2738030, FAX (202) 2735981 or e mail: email@example.com. Please refer to ``OMB Control No. 29000060.''
Send comments and recommendations concerning any aspect of the information collection to VA's OMB Desk Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC 20503 (202) 3957316. Please refer to ``OMB Control No. 29000060'' in any correspondence.