View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 2900-0020	ICR Reference No: 201912-2900-004
Status: Historical Active	Previous ICR Reference No: 201512-2900-025
Agency/Subagency: VA	Agency Tracking No: VBA-INS-NK
Title: Designation of Beneficiary - Government Life Insurance and Supplemental Designation of Beneficiary (VA Forms 29-336 and 29-336a )
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/09/2020
	Date Received in OIRA: 06/09/2020
Terms of Clearance: VA shall display the expiration date included, but is authorized to accept prior versions of forms for OMB 2900-0020. VA shall also comply with 38 USC 5126 in its processing of these forms. In its next revision, extension, or reinstatement request, VA will explain why a guardian or POA cannot sign these forms.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2023	36 Months From Approved
Responses	83,500	0	0
Time Burden (Hours)	13,917	0	0
Cost Burden (Dollars)	0	0	0

Annual Cost to Federal Government: $806,664

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: Danny Green 202 421-1354 danny.green2@va.gov

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.