Information Collection

Compensation and Pension Examination Program (CPEP) Veterans Satisfaction Survey

IC 191626 under ICR 201211-2900-005 · OMB 2900-0774.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 10-0480 Compensation and Pension Examination Program (CPEP) Veterans Satisfaction Survey	Form
VA Form 10-0480 Compensation and Pension Examination Program (CPEP) Vete CPEP survey instrument3.pdf Weblink to be determined	Form

IC Title:

Agency IC Tracking Number:

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 10-0480	Compensation and Pension Examination Program (CPEP) Veterans Satisfaction Survey	CPEP survey instrument3.pdf	Weblink to be determined	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,055

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	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	1,614	1,614
Annual IC Time Burden (Hours)	153	153
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.