Information Collection

VA Smoking Cessation Clients Call Backs

IC 219413 under ICR 201807-0925-001 · OMB 0925-0208.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0208 can be found here:

Documents and Forms

Document Name Document Type
Form 6 VA Smoking Cessation Clients Call Backs Form
6 VA Smoking Cessation Call Backs Appendix 1D Smoking Call Back Task_updated AG.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	VA Smoking Cessation Clients Call Backs	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	6	VA Smoking Cessation Call Backs	Appendix 1D Smoking Call Back Task_updated AG.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,560	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	Previously Approved
Annual Number of Responses for this IC	1,560	-4,600	6,160
Annual IC Time Burden (Hours)	104	1	103
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.