Information Collection

2013 659 FDA Mobile - 2013 686 VA Medical Centers

IC 208264 under ICR 201110-1090-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 659 2013 659 FDA Mobile - 2013 686 VA Medical Centers	Form and Instruction
659 2013 659 FDA Mobile 2013 659 FDA Mobile - Final to OMB.xlsx	Form and Instruction
660 2013 660 NOAA NOS CO-OPS 2013 660 NOAA NOS CO-OPS Questionnaire Final Draft 8 16 13 -For OMB Clearance.xlsx	Form and Instruction
661 2013 661 Alumni Questionnaire Master 2013 661 Alumni Questionnaire Master 2-15-13.xlsx	Form and Instruction
662 2013 662 BSO v2 2013 662 BSO v2.xlsx	Form and Instruction
663 2013 663 CFTC V2 Questionnaire 2013 663 CFTC V2 Questionnaire Jan 7 2013.xlsx	Form and Instruction
664 2013 664 DHS CIS Spanish 2013 664 DHS CIS Spanish 8-4-11.xlsx	Form and Instruction
665 2013 665 Disability v2 2013 665 Disability v2.xlsx	Form and Instruction
666 2013 666 DOT Intranet 2013 666 DOT Intranet 7-15-2010.xlsx	Form and Instruction
667 2013 667 EPA Questionnaire 2013 667 EPA Questionnaire 8.1.13.xlsx	Form and Instruction
668 2013 668 Exchanges v2 Questionnaire 2013 668 Exchanges v2 Questionnaire 9-14-2012.xlsx	Form and Instruction
669 2013 669 ExtraHelp v3 with Spanish Translations 2013 669 ExtraHelp v3 with Spanish Translations.xlsx	Form and Instruction
670 2013 FRA Questionnaire 2013 670 FRA Questionnaire June 12 2013.xlsx	Form and Instruction
671 2013 671 FulBright Questionnaire 2013 671 FulBright Questionnaire v2 3-24-11.xlsx	Form and Instruction
672 2013 672 iClaims v3 2013 672 iClaims v3_.xlsx	Form and Instruction
673 2013 673 main v3 2013 673 main v3 Survey.xlsx	Form and Instruction
674 2013 674 MedlinePlus Mobile 2013 674 MedlinePlus Mobile _8-30-12.xlsx	Form and Instruction
675 2013 675 MedlinePlus Survey Spanish 2013 675 MedlinePlus Survey Spanish_9-26-2011.xlsx	Form and Instruction
676 2013 676 MedlinePlus Survey 2013 676 MedlinePlus Survey_8-10-2010.xlsx	Form and Instruction
677 2013 677 My Social Security v2 CQ changes 2013 677 My Social Security v2 CQ changes July 2013.xlsx	Form and Instruction
678 2013 678 NIDDK Questionnaire 2013 678 NIDDK Questionnaire June 5 2012.xlsx	Form and Instruction
679 2013 679 NIH NIAD 2013 679 NIH NIAD 2012.xlsx	Form and Instruction
680 2013 680 NLA Main Site CQ change 2013 680 NLA Main Site CQ changes.xlsx	Form and Instruction
681 2013 681 NLM Clinical Trails Site Feedback 2013 681 NLM Clinical Trials Site Feedback_1-9-13.xlsx	Form and Instruction
682 2013 682 Retirement Estimator v4 with Spanish Translatio 2013 682 Retirement Estimator v4 with Spanish Translations.xlsx	Form and Instruction
683 2013 683 SSA FAQ v3 2013 683 SSA FAQ v3.xlsx	Form and Instruction
684 2013 684 USCIS CQ Changes 2013 684 USCIS CQ Changes.xlsx	Form and Instruction
685 2013 685 VBA Survey 2013 685 VBA Survey.xlsx	Form and Instruction
686 2013 686 VHA Medical Centers Questionnaire Redesign Ques 2013 686 VHA Medical Centers Questionnaire Redesign Questions April 8 2013.xlsx	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

2013 659 FDA Mobile - 2013 686 VA Medical Centers

Agency IC Tracking Number:

659 - 686

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?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	659	2013 659 FDA Mobile	2013 659 FDA Mobile - Final to OMB.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	660	2013 660 NOAA NOS CO-OPS	2013 660 NOAA NOS CO-OPS Questionnaire Final Draft 8 16 13 -For OMB Clearance.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	661	2013 661 Alumni Questionnaire Master	2013 661 Alumni Questionnaire Master 2-15-13.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	662	2013 662 BSO v2	2013 662 BSO v2.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	663	2013 663 CFTC V2 Questionnaire	2013 663 CFTC V2 Questionnaire Jan 7 2013.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	664	2013 664 DHS CIS Spanish	2013 664 DHS CIS Spanish 8-4-11.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	665	2013 665 Disability v2	2013 665 Disability v2.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	666	2013 666 DOT Intranet	2013 666 DOT Intranet 7-15-2010.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	667	2013 667 EPA Questionnaire	2013 667 EPA Questionnaire 8.1.13.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	668	2013 668 Exchanges v2 Questionnaire	2013 668 Exchanges v2 Questionnaire 9-14-2012.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	669	2013 669 ExtraHelp v3 with Spanish Translations	2013 669 ExtraHelp v3 with Spanish Translations.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	670	2013 FRA Questionnaire	2013 670 FRA Questionnaire June 12 2013.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	671	2013 671 FulBright Questionnaire	2013 671 FulBright Questionnaire v2 3-24-11.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	672	2013 672 iClaims v3	2013 672 iClaims v3_.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	673	2013 673 main v3	2013 673 main v3 Survey.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	674	2013 674 MedlinePlus Mobile	2013 674 MedlinePlus Mobile _8-30-12.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	675	2013 675 MedlinePlus Survey Spanish	2013 675 MedlinePlus Survey Spanish_9-26-2011.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	676	2013 676 MedlinePlus Survey	2013 676 MedlinePlus Survey_8-10-2010.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	677	2013 677 My Social Security v2 CQ changes	2013 677 My Social Security v2 CQ changes July 2013.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	678	2013 678 NIDDK Questionnaire	2013 678 NIDDK Questionnaire June 5 2012.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	679	2013 679 NIH NIAD	2013 679 NIH NIAD 2012.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	680	2013 680 NLA Main Site CQ change	2013 680 NLA Main Site CQ changes.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	681	2013 681 NLM Clinical Trails Site Feedback	2013 681 NLM Clinical Trials Site Feedback_1-9-13.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	682	2013 682 Retirement Estimator v4 with Spanish Translations	2013 682 Retirement Estimator v4 with Spanish Translations.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	683	2013 683 SSA FAQ v3	2013 683 SSA FAQ v3.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	684	2013 684 USCIS CQ Changes	2013 684 USCIS CQ Changes.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	685	2013 685 VBA Survey	2013 685 VBA Survey.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	686	2013 686 VHA Medical Centers Questionnaire Redesign Questions	2013 686 VHA Medical Centers Questionnaire Redesign Questions April 8 2013.xlsx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100,800

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100,800	100,800
Annual IC Time Burden (Hours)	4,200	4,200
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.