Information Collection

Mobile App Field Testing (VHA OCC)

IC 236307 under ICR 201710-2900-001 · OMB 2900-0770.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
VHA OCC Mobile App Field Testing Instrument_May 2019.docx	Other-Survey
VHA OCC Mobile App Field Testing_PRA Generic Clearance Statement_May 2019.docx VHA OCC Mobile App Field Testing Instrument	IC Document

IC Title:

Mobile App Field Testing (VHA OCC)

Agency IC Tracking Number:

2900-0770

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
Other-Survey			VHA OCC Mobile App Field Testing Instrument_May 2019.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 950

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	950	950
Annual IC Time Burden (Hours)	950	950
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
VHA OCC Mobile App Field Testing Instrument	VHA OCC Mobile App Field Testing_PRA Generic Clearance Statement_May 2019.docx	05/31/2019

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