VE Feedback Tool: eComment Card

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCA, VBA, VHA)

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

IC Title:	VE Feedback Tool: eComment Card	Agency IC Tracking Number:

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-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 %

	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

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.