Information Collection

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

IC 193844 under ICR 201101-1090-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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: Unchanged

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?	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 %

table that charts list of burden
	Requested	Previously Approved
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

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.