Information Collection

VAInfoApp

IC 220440 under ICR 201403-2900-007 · OMB 2900-0770.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0770 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-1500199(WS) VAInfoApp	Form and Instruction
10-1500199(WS) MySurvey VAInfoApp.pdf	Form and Instruction
VA Generic Fast-Track Clearance Request VAInfoApp Questionnare.docx VAInfoApp	IC Document

IC Title:

VAInfoApp

Agency IC Tracking Number:

2900-0770

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
Form and Instruction	10-1500199(WS)	MySurvey	VAInfoApp.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

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	30	30
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
VAInfoApp	VA Generic Fast-Track Clearance Request VAInfoApp Questionnare.docx	03/23/2016

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.