Application for Ordinary Life Insurance (Age 65 and 70) (VA Forms 29-8485 & 29-8485a)

OMB 2900-0166

These forms are used by the insured to apply for replacement insurance for Modified Life at Age 65 and 70.

The latest form for Application for Ordinary Life Insurance (Age 65 and 70) (VA Forms 29-8485 & 29-8485a) expires 2021-05-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form VBA-29-8485 Application for Ordinary Life Insurance (Age 65 and 70) VA Forms 29-8485 and 29-8485a Form
30-DAY FRN 2900-0166.pdf Supplementary Document
2900-0166, Supporting Statement NEW.docx Supporting Statement A
60-DAY FRN 2900-0166 (published).pdf Supplementary Document
Application for Ordinary Life Insurance (Age 65 and 70) VA Forms 29-8485 and 29-8485a Form

All Historical Document Collections

202404-2900-011	Extension without change of a currently approved collection	2024-09-11
202105-2900-011 Approved without change	Reinstatement with change of a previously approved collection	2021-08-12
201711-2900-002 Approved without change	Reinstatement without change of a previously approved collection	2018-03-19
201312-2900-005 Approved without change	Revision of a currently approved collection	2014-08-22
201104-2900-012 Approved without change	Extension without change of a currently approved collection	2011-07-11
200803-2900-003 Approved without change	Extension without change of a currently approved collection	2008-07-10
200505-2900-007 Approved without change	Extension without change of a currently approved collection	2005-05-11
200203-2900-002 Approved without change	Reinstatement without change of a previously approved collection	2002-03-05
200108-2900-002 Disapproved	Reinstatement without change of a previously approved collection	2001-08-02
199803-2900-006 Approved without change	Extension without change of a currently approved collection	1998-03-18
199503-2900-009 Approved without change	Reinstatement without change of a previously approved collection	1995-03-24
199012-2900-006 Approved without change	Reinstatement with change of a previously approved collection	1990-12-12
198706-2900-002 Approved without change	Revision of a currently approved collection	1987-06-16
198608-2900-050 Approved with change	No material or nonsubstantive change to a currently approved collection	1986-08-08
198406-2900-013 Approved without change	Revision of a currently approved collection	1984-06-20
198209-2900-028 Approved with change	No material or nonsubstantive change to a currently approved collection	1982-09-07
198104-2900-009 Approved without change	Revision of a currently approved collection	1981-04-17
197606-2900-027 Approved without change	Revision of a currently approved collection	1976-06-22
197606-2900-026 Approved without change	Revision of a currently approved collection	1976-06-03