Information Collection

LIGHT Survey

IC 226123 under ICR 201703-2900-014 · OMB 2900-0870.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
T1 LIGHT Male Survey.pdf	Other-Survey
T2 LIGHT Male Survey_with PRA.pdf	Other-Survey
T3 LIGHT Male Survey_with PRA.pdf	Other-Survey
T1 LIGHT Female Survey.pdf	Other-Survey
T2 LIGHT Female Survey_with PRA.pdf	Other-Survey
T3 LIGHT Female Survey_with PRA.pdf	Other-Survey
T4 LIGHT Male Survey_with PRA.docx	Other-Survey
T4 LIGHT Female Survey_with PRA.docx	Other-Survey

IC Title:

LIGHT Survey

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	Instrument File	Available Electronically?	Electronic Capability
Other-Survey	T1 LIGHT Female Survey.pdf	No	Paper Only
Other-Survey	T2 LIGHT Female Survey_with PRA.pdf	No	Paper Only
Other-Survey	T3 LIGHT Male Survey_with PRA.pdf	No	Paper Only
Other-Survey	T3 LIGHT Female Survey_with PRA.pdf	No	Paper Only
Other-Survey	T4 LIGHT Male Survey_with PRA.docx	No	Paper Only
Other-Survey	T4 LIGHT Female Survey_with PRA.docx	No	Paper Only
Other-Survey	T2 LIGHT Male Survey_with PRA.pdf	No	Paper Only
Other-Survey	T1 LIGHT Male Survey.pdf	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Veteran, Patient, Employee and Volunteer Research and Development Project Records-VA 34VA12

FR Citation: 59 FR 16705

Number of Respondents: 16,000

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	16,000	16,000
Annual IC Time Burden (Hours)	12,000	12,000
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.