Information Collection

Veterans Outcome Assessment

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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
VOA_Survey_20141113.docx	Other-Script

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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	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 %

table that charts list of burden
	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

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.