Information Collection

Partner Survey - Private Sector

IC 209828 under ICR 201502-0970-009 · OMB 0970-0444.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0444 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Partner Survey Partner Survey - Private Sector	Form and Instruction
VA Partner Survey VA Partner Survey VA Partner Survey.pdf	Form and Instruction
VB Partner Survey FAQ.pdf VB Partner Survey FAQ	IC Document
VC Partner Survey Advance Email.pdf VC Partner Survey Advance Email	IC Document
VD Partner Survey Email Invitation.pdf VD Partner Survey Email Invitation	IC Document
VE Partner Survey Reminder Email.pdf VE Partner Survey Reminder Email	IC Document
VF Partner Survey Final Reminder Email.pdf VF Partner Survey Final Reminder Email	IC Document
VG Partner Survey Grantee Reminder Request.pdf VG Partner Survey Grantee Reminder Request	IC Document
VH Partner Survey Thank-You Email.pdf VH Partner Survey Thank-You Email	IC Document

IC Title:

Partner Survey - Private Sector

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 42 CFR B (To search for a specific CFR, visit the Code of Federal Regulations.)

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	VA Partner Survey	VA Partner Survey	VA Partner Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title: Records maintained on individuals

FR Citation: 5 FR 43

Number of Respondents: 240

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	79	-42	121
Annual IC Time Burden (Hours)	26	-14	40
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
VB Partner Survey FAQ	VB Partner Survey FAQ.pdf	12/09/2013
VC Partner Survey Advance Email	VC Partner Survey Advance Email.pdf	12/09/2013
VD Partner Survey Email Invitation	VD Partner Survey Email Invitation.pdf	12/09/2013
VE Partner Survey Reminder Email	VE Partner Survey Reminder Email.pdf	12/09/2013
VF Partner Survey Final Reminder Email	VF Partner Survey Final Reminder Email.pdf	12/09/2013
VG Partner Survey Grantee Reminder Request	VG Partner Survey Grantee Reminder Request.pdf	12/09/2013
VH Partner Survey Thank-You Email	VH Partner Survey Thank-You Email.pdf	12/09/2013

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