Information Collection

VA Homeless Program - Customer Feedback Survey

IC 238195 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
HPO_Customer Feedback Survey_Generic PRA Clearance_OMB passback_FINAL_04232020.docx Other-Survey
Generic Supp Statement_VA Homeless Prog - Cust Feedback Survey_revised_2020.docx Generic Supp Stmnt - VA Homeless Program - Customer Feedback Survey IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	VA Homeless Program - Customer Feedback Survey	Agency IC Tracking Number:	2900-0770

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			HPO_Customer Feedback Survey_Generic PRA Clearance_OMB passback_FINAL_04232020.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 18,000	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	18,000	18,000
Annual IC Time Burden (Hours)	3,000	3,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Supp Stmnt - VA Homeless Program - Customer Feedback Survey	Generic Supp Statement_VA Homeless Prog - Cust Feedback Survey_revised_2020.docx	02/28/2020

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