Information Collection

Health-Care Use Survey for Enduring Freedom and Operation Iraqi Freedom Veterans

IC 191043 under ICR 200910-2900-003 · OMB 2900-0765.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 10-0478 Health-Care Use Survey for Enduring Freedom and Operation Iraqi Freedom Veterans	Form and Instruction
VA Form 10-0478 Health Care Use Survey for Enduring Freedom and Operatio VA Form 10-0478_Health-Care Use Survey (v4)[1].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 10-0478	Health Care Use Survey for Enduring Freedom and Operation Iraqi Freedom Veterans	VA Form 10-0478_Health-Care Use Survey (v4)[1].pdf		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Veteran, Patient, Employee and Volunteer Research and Development Project Records - VA (34VA11)

FR Citation: 40 FR 38095

Number of Respondents: 1,410

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	1,410	1,410
Annual IC Time Burden (Hours)	1,058	1,058
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.