Skip to Content


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

Document Details

Information about this document as published in the Federal Register.

Enhanced Content

Relevant information about this document from provides additional context. This information is not part of the official Federal Register document.

Published Document

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

Start Preamble


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 September 26, 2013.


Submit written comments on the collection of information through, or to Office of Information and Regulatory Affairs, Office of Management and Budget, Attn: VA Desk Officer; 725 17th St. NW., Washington, DC 20503 or sent through electronic mail to Please refer to “OMB Control No. 2900-0060” in any correspondence.

Start Further Info


Crystal Rennie, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632-7492 or email Please refer to “OMB Control No. 2900-0060.”

End Further Info End Preamble Start Supplemental Information



a. Claim for One Sum Payment (Government Life Insurance), VA Form 29-4125.Start Printed Page 53015

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.

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 March 26, 2013, at pages 18424-18425.

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.

Start Signature

Dated: August 22, 2013.

By direction of the Secretary:

Crystal Rennie,

VA Clearance Officer, U.S. Department of Veterans Affairs.

End Signature End Supplemental Information

[FR Doc. 2013-20889 Filed 8-26-13; 8:45 am]