Information Collection

VA NCA Online and Telephone Survey Education Program Research

IC 216784 under ICR 201505-2900-017 · OMB 2900-0841.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 40-10166 VA NCA Online and Telephone Survey Education Program Research	Form and Instruction
VA Form 40-10166 Questionnaire for Online / Telephone Survey of Non-Acade VA Form 40-10166 Online Survey of Non-Academic Audiences_1.pdf link to ADRG website TBD	Form and Instruction

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
Form and Instruction	VA Form 40-10166	Questionnaire for Online / Telephone Survey of Non-Academic Audiences	VA Form 40-10166 Online Survey of Non-Academic Audiences_1.pdf	link to ADRG website TBD	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

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.