Information Collection

e-Benefits Portal

IC 190169 under ICR 201210-2900-006 · OMB 2900-0737.

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.