Information Collection

Survey of Veterans in the Program of Comprehensive Assistance for Family Caregivers (PCAFC)

IC 231784 under ICR 201806-2900-002 · OMB 2900-0871.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PCAFC_VETERAN SURVEY_OMB passback revisions_07242019.docx	Other-Survey

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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			PCAFC_VETERAN SURVEY_OMB passback revisions_07242019.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 8,100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	8,100	8,100
Annual IC Time Burden (Hours)	2,025	2,025
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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