Information Collection

Online survey about advocates' work history and demographics

IC 226033 under ICR 201701-0990-004 · OMB 0990-0458.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0458 can be found here:

Documents and Forms

Document Name Document Type
DVHF_Advocate Demographics and Work History_OMB CLEAN 8.9.17.docx Other-survey

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Online survey about advocates' work history and demographics	Agency IC Tracking Number:

Is this a Common Form? No		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-survey			DVHF_Advocate Demographics and Work History_OMB CLEAN 8.9.17.docx		No		Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.