Information Collection

Veterans Transportation Service Questionnaire

IC 210632 under ICR 201107-2900-001 · OMB 2900-0770.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0770 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
White paper for Transportation survey 1 9 14.docx	Other-Additional questions to previo
Notice of Approval.pdf Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	IC Document

IC Title:

Veterans Transportation Service Questionnaire

Agency IC Tracking Number:

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
Other-Additional questions to previously approved questionnaire			White paper for Transportation survey 1 9 14.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,000

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	2,000	2,000
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Notice of Approval.pdf	03/10/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.