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Agency Information Collection (Claim for One Sum Payment (Government Life Insurance)) Activities under OMB Review

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Information about this document as published in the Federal Register.

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This document has been published in the Federal Register. Use the PDF linked in the document sidebar for the official electronic format.

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Veterans Benefits Administration, Department of Veterans Affairs.




In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice announces that the Veterans Benefits Administration (VBA), Department of Veterans Affairs, will submit 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.


Comments must be submitted on or before December 29, 2010.


Submit written comments on the collection of information through; or to VA's OMB Desk Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC 20503 (202) 395-7316. Please refer to “OMB Control No. 2900-0060” in any correspondence.

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Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 461-7485, fax (202) 273-0443 or e-mail Please refer to “OMB Control No. 2900-0060.”

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a. Claim for One Sum Payment (Government Life Insurance), VA Form 29-4125.

b. Claim for Monthly Payments (National Service Life Insurance), VA Form 29-4125a.

c. Claim for Monthly Payments (United States Government Life Insurance, (USGLI)), VA Form 29-4125k.

OMB Control Number: 2900-0060.Start Printed Page 73167

Type of Review: Extension of a currently approved collection.

Abstract: Beneficiaries of deceased veterans must complete VA Form 29-4125 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 29-4125a and 29-4125k. 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 60-day comment period soliciting comments on this collection of information was published on September 16, 2010, at page 56664.

Affected Public: Individuals or households.

Estimated Annual Burden:

a. VA Form 29-4125—8,200 hours.

b. VA Form 29-4125a—185 hours.

c. VA Form 4125k—125 hours.

Estimated Average Burden per Respondents:

a. VA Form 29-4125—6 minutes.

b. VA Form 29-4125a—6 minutes.

c. VA Form 4125k—15 minutes.

Frequency of Response: On occasion.

Estimated Number of Respondents:

a. VA Form 29-4125—82,000.

b. VA Form 29-4125a—1,850.

c. VA Form 4125k—500.

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Dated: November 23, 2010.

By direction of the Secretary.

Denise McLamb,

Program Analyst, Enterprise Records Service.

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[FR Doc. 2010-29933 Filed 11-26-10; 8:45 am]