Information Collection

Veterans Outcome Assessment

IC 211770 under ICR 201402-2900-006 · OMB 2900-0825.

Documents and Forms

Document Name Document Type
VOA_Survey_20141113.docx Other-Script

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Veterans Outcome Assessment	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Script			VOA_Survey_20141113.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,280	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,280	4,280
Annual IC Time Burden (Hours)	2,140	2,140
Annual IC Cost Burden (Dollars)	51,360	51,360

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.