Information Collection

Operation Enduring Freedom/Operation Iraqi Freedom Veterans Health Needs Assessment Survey

IC 186170 under ICR 200808-2900-003 · OMB 2900-0728.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form Number 10- Operation Enduring Freedom/Operation Iraqi Freedom Veterans Health Needs Assessment Survey	Form and Instruction
VA Form Number 10- Operation Enduring Freedom/Operation Iraqi Freedom Veter OEF-OIF Health Needs Assessment Survey 10-21091.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	VA Form Number 10-21091	Operation Enduring Freedom/Operation Iraqi Freedom Veterans Health Needs Assessment	OEF-OIF Health Needs Assessment Survey 10-21091.pdf		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	1,000	1,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.