Information Collection

Veterans Health Administration (VHA) Six Month Post-Exit Focus Interview of Former VHA Employees

IC 192803 under ICR 201005-2900-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 10-0487 Veterans Health Administration (VHA) Six Month Post-Exit Focus Interview of Former VHA Employees	Form
VA Form 10-0487 VHA Six-Month Post-Exit Focus Interview Questions Post-Exit_Interview_Survey_Questions[1].doc To Be Determined	Form

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	VA Form 10-0487	VHA Six-Month Post-Exit Focus Interview Questions	Post-Exit_Interview_Survey_Questions[1].doc	To Be Determined	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,500

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	750	750
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.