Information Collection

VE Feedback Tool: eComment Card

IC 226212 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⚠️ Notice: This information collection may be referencing outdated material.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
VE Feedback Tool - Info Sheet_03.16.2017.pdf survey.voice.medallia.com/?vavoice-vftsurvey#	Other-Web: eComment Card
VE Feedback Tool - Generic Clearance Request (OMB 2900-0770)_03.15.2017.docx VE Feedback Tool Generic Request	IC Document

IC Title:

VE Feedback Tool: eComment Card

Agency IC Tracking Number:

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-Web: eComment Card			VE Feedback Tool - Info Sheet_03.16.2017.pdf	https://survey.voice.medallia.com/?vavoice-vftsurvey#	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 135

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	135	135
Annual IC Time Burden (Hours)	11	11
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
VE Feedback Tool Generic Request	VE Feedback Tool - Generic Clearance Request (OMB 2900-0770)_03.15.2017.docx	03/27/2017

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