OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

DoD COVID-19 Vaccine Questionnaire

IC 248153 under ICR 202201-0720-002 · OMB 0720-0069.

Documents and Forms
Document Name
Document Type
Other-Questionnaire
Other-Questionnaire
Other-AudioCare System
Other-AudioCare System
Information Collection (IC) Details

View Information Collection (IC)

DoD COVID-19 Vaccine Questionnaire
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Questionnaire 0720-DCVQ-DoD COVID Vaccine Questionnaire 6.11.2021.docx Yes Yes Fillable Fileable
Other-AudioCare System 0720-DCVQ-DoD COVID Vaccine Questionnaire-AudioCARE 6.11.2021.docx Yes Yes Fillable Fileable

Defense and National Security Operational Defense

 

570,000 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 570,000 0 0 0 0 570,000
Annual IC Time Burden (Hours) 19,000 0 0 0 0 19,000
Annual IC Cost Burden (Dollars) 565,060 0 760 0 0 564,300

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.