Information Collection

379 IRS LB & I Q's, 380 VHAInpatient_Survey_10_Final, 381 VHAOutpatient_Survey_10_Final

IC 195191 under ICR 200908-1090-001 · OMB 1090-0007.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0007 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 379 IRS LB & I Que 379 IRS LB & I Q's, 380 VHAInpatient_Survey_10_Final, 381 VHAOutpatient_Survey_10_Final	Form
379 IRS LB & I Que 379 IRS LB & I Questionnaire 2010 379 IRS LB & I Questionnaire.docx	Form
380 VHAInpatient_S 380 VHAInpatient_Survey_10_Final 2010 380 VHAInpatient_Survey_10_Final.doc	Form
381 VHAOutpatient_ 381 VHAOutpatient_Survey_10_Final 2010 381 VHAOutpatient_Survey_10_Final.doc	Form

IC Title:

379 IRS LB & I Q's, 380 VHAInpatient_Survey_10_Final, 381 VHAOutpatient_Survey_10_Final

Agency IC Tracking Number:

379-381

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	Available Electronically?	Electronic Capability
Form	379 IRS LB & I Questionnaire	379 IRS LB & I Questionnaire	2010 379 IRS LB & I Questionnaire.docx	No	Paper Only
Form	380 VHAInpatient_Survey_10_Final	380 VHAInpatient_Survey_10_Final	2010 380 VHAInpatient_Survey_10_Final.doc	No	Paper Only
Form	381 VHAOutpatient_Survey_10_Final	381 VHAOutpatient_Survey_10_Final	2010 381 VHAOutpatient_Survey_10_Final.doc	No	Paper Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 750

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	750	750
Annual IC Time Burden (Hours)	125	125
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.