e-Benefits Portal

E-Benefits Portal

Documents and Forms

Document Name Document Type
e-Benefits ProfileFormv2.ppt www.ebenefits.va.gov Other-portal
2900-0737 Registration Form.ppt www.ebenefits.va.gov Other-Registration Form
eBenefits_WireframesRelease2-4_RequestStateBenefitInformation.pdf Other-information
eBenefits_WireframesRelease2-6_CustomerFeedback_v10.pdf Other-survey

Information Collection (IC) Details

IC Title:	e-Benefits Portal	Agency IC Tracking Number:	2900-0737 VBA-BAS

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey	eBenefits_WireframesRelease2-6_CustomerFeedback_v10.pdf		Yes	Yes	Fillable Fileable
Other-portal	e-Benefits ProfileFormv2.ppt	www.ebenefits.va.gov	Yes	Yes	Fillable Fileable
Other-Registration Form	2900-0737 Registration Form.ppt	www.ebenefits.va.gov	Yes	Yes	Fillable Fileable
Other-information	eBenefits_WireframesRelease2-4_RequestStateBenefitInformation.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,600,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,600,000	-100,000	2,700,000
Annual IC Time Burden (Hours)	86,667	-138,333	225,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.