Information Collection

Mapping and Questionnaire Documents IA 30687 A3 (VA)

IC 235036 under ICR 201805-1090-003 · OMB 1090-0008.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0008 can be found here:

Documents and Forms

Document Name Document Type
Form 30687 Mapping and Questionnaire Documents IA 30687 A3 (VA) Form and Instruction
30687 Q_VBA_Web_Browse_20160107_DOT Q_VBA_Web_Browse_20160107_DOT.xls Form and Instruction
1090-0008 Survey Mapping Document (VA) IA 30687 A3.xlsx 1090-0008 Survey Mapping Document (VA) IA 30687 A3 IC Document
VA OMB Form 11.13.2018 IA 30687 A3.pdf VA OMB Form 11.13.2018 IA 30687 A3 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Mapping and Questionnaire Documents IA 30687 A3 (VA)	Agency IC Tracking Number:	30687 A3

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
Form and Instruction	30687	Q_VBA_Web_Browse_20160107_DOT	Q_VBA_Web_Browse_20160107_DOT.xls		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,600	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	3,600	3,600
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
1090-0008 Survey Mapping Document (VA) IA 30687 A3	1090-0008 Survey Mapping Document (VA) IA 30687 A3.xlsx	02/21/2019
VA OMB Form 11.13.2018 IA 30687 A3	VA OMB Form 11.13.2018 IA 30687 A3.pdf	02/21/2019

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