2020 045 MyHealtheVet Mobile Nov 2020 (1)

E-Government Website Customer Satisfaction Surveys

⚠️ Notice: This information collection may be referencing outdated material.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 045 2020 045 MyHealtheVet Mobile Nov 2020 (1) Form and Instruction
045 2020 045 MyHealtheVet Mobile Nov 2020 (1) 2020 045 MyHealtheVet Mobile Nov 2020 (1).xlsx Form and Instruction
1090-0008 Survey Mapping Document (VHA) IA 30820.xlsx 1090-0008 Survey Mapping Document (VHA) IA 30820 IC Document
1090-0008 Generic Clearance Request Form MyHealtheVet Mobile Signed.pdf 1090-0008 Generic Clearance Request Form MyHealtheVet Mobile Signed IC Document

Information Collection (IC) Details

IC Title:	2020 045 MyHealtheVet Mobile Nov 2020 (1)	Agency IC Tracking Number:	045 resubmission

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	045	2020 045 MyHealtheVet Mobile Nov 2020 (1)	2020 045 MyHealtheVet Mobile Nov 2020 (1).xlsx		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: 2,500	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	2,500	2,500
Annual IC Time Burden (Hours)	125	125
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
1090-0008 Survey Mapping Document (VHA) IA 30820	1090-0008 Survey Mapping Document (VHA) IA 30820.xlsx	12/07/2020
1090-0008 Generic Clearance Request Form MyHealtheVet Mobile Signed	1090-0008 Generic Clearance Request Form MyHealtheVet Mobile Signed.pdf	12/07/2020

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