Information Collection

CQs 7-6-2010 to 7-18-2010 DOT VERSION_VHA_Medical_Centers Hoosier Lottery (State of Indiana)

IC 193844 under ICR 200905-1090-001 · OMB 1090-0008.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0008 can be found here:

Documents and Forms

Document Name Document Type
Form 339 CQs for OMB 7- CQs 7-6-2010 to 7-18-2010 DOT VERSION_VHA_Medical_Centers Hoosier Lottery (State of Indiana) Form
339 CQs for OMB 7- 339 CQs for OMB 7-6-2010 to 7-18-2010 2010 339 CQs for OMB 7-6-2010 to 7-18-2010.xlsx Form
340 DOT VERSION_VH 340 DOT VERSION_VHA_Medical_Centers_Questionnaire_Templa 2010 340 DOT VERSION_VHA_Medical_Centers_Questionnaire_Template.xls Form
341 Hoosier Lotter 341 Hoosier Lottery (State of Indiana) Questionnaire Fin 2010 341 Hoosier Lottery (State of Indiana) Questionnaire Final 7.8.10.xlsx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CQs 7-6-2010 to 7-18-2010 DOT VERSION_VHA_Medical_Centers Hoosier Lottery (State of Indiana)	Agency IC Tracking Number:	339-341

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	339 CQs for OMB 7-6-2010 to 7-18-2010	339 CQs for OMB 7-6-2010 to 7-18-2010	2010 339 CQs for OMB 7-6-2010 to 7-18-2010.xlsx	Yes	Yes	Fillable Fileable
Form	340 DOT VERSION_VHA_Medical_Centers_Questionnaire_	340 DOT VERSION_VHA_Medical_Centers_Questionnaire_Template	2010 340 DOT VERSION_VHA_Medical_Centers_Questionnaire_Template.xls	Yes	Yes	Fillable Fileable
Form	341 Hoosier Lottery (State of Indiana) Questionnai	341 Hoosier Lottery (State of Indiana) Questionnaire Final 7.8.10	2010 341 Hoosier Lottery (State of Indiana) Questionnaire Final 7.8.10.xlsx	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	15,000	15,000
Annual IC Time Burden (Hours)	625	625
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.