Information Collection

VPN User Survey

IC 216474 under ICR 201804-0917-001 · OMB 0917-0036.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0917-0036 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0917-0036 VPN User Survey	Form and Instruction
0917-0036 VPN User Survey OMB No 0917-0036-22 IHS VPN User Survey - 2015.docx	Form and Instruction
Generic Clearance Submission - IHS VPN Survey - 2015.doc OMB No. 0917-0036, Mini-Supporting Statement for VPN User Survey	IC Document

IC Title:

VPN User Survey

Agency IC Tracking Number:

IC Status: Removed

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	0917-0036	VPN User Survey	OMB No 0917-0036-22 IHS VPN User Survey - 2015.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 220

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-220	220
Annual IC Time Burden (Hours)	-18	18
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB No. 0917-0036, Mini-Supporting Statement for VPN User Survey	Generic Clearance Submission - IHS VPN Survey - 2015.doc	05/07/2015

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