OMB control number
Authorization to Disclose Information to a Third Party (Insurance) (VA Forms 29-0975 & 29-0975e)
OMB 2900-0856 · VA.
OMB 2900-0856
The VA Forms 29-0975 & 29-0975e will be used by the Department of Veterans Affairs Insurance Center (VAIC) to enable a third party to act on behalf of the insured Veteran/beneficiary. Many of our customers are of advanced age or suffer from limiting disabilities and need assistance from a third party to conduct their affairs. The information collected provides an optional service and is not required to receive insurance benefits.
The latest form for Authorization to Disclose Information to a Third Party (Insurance) (VA Forms 29-0975 & 29-0975e) expires 2027-04-30 and can be found here.
Latest Forms, Documents, and Supporting Material
Document Name |
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Form |
Supporting Statement A |
Supplementary Document |
Supplementary Document |
Form VA Form 29-0975 AUTHORIZATION TO DISCLOSE PERSONAL INFORMATION TO A THIRD PARTY (INSURANCE)
SupportState(2900-0856).docx
2024-05553.pdf
AUTHORIZATION TO DISCLOSE PERSONAL INFORMATION TO A THIRD PARTY (INSURANCE) All Historical Document Collections
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Approved with change |
Extension without change of a currently approved collection | 2024-03-18 | |
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Approved with change |
No material or nonsubstantive change to a currently approved collection | 2022-06-24 | |
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Approved without change |
Reinstatement with change of a previously approved collection | 2021-02-09 | |
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Approved without change |
New collection (Request for a new OMB Control Number) | 2017-09-14 |