Information Collection

VA.gov A-11 Surveys

IC 258501 under ICR 202503-2900-010 · OMB 2900-0876.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0876 can be found here:

2025-11-26 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA.gov VFS Questio VA.gov A-11 Surveys	Form and Instruction
Form VA.gov VFS Questio VA.gov VFS Questionnaire - 01202023 HF VA.gov A-11 Surveys	Form and Instruction
Form VA.gov VFS - Searc VA.gov VFS - Search Questionnaire - 01202023 HF VA.gov A-11 Surveys	Form and Instruction
Form VA.gov VFS - ChatB VA.gov VFS - ChatBot Questionnaire - 01202023 HF VA.gov A-11 Surveys	Form and Instruction
Form VA.gov A11 Questio VA.gov A11 Questionnaire - 01202023 HF VA.gov A-11 Surveys	Form and Instruction
VA.gov VFS Questio VA.gov VFS Questionnaire - 01202023 HF VA.gov VFS Questionnaire - 01202023 HF.pdf	Form and Instruction
VA.gov VFS Questio VA.gov VFS Questionnaire - 01202023 HF VA.gov VFS Questionnaire - 01202023 HF.pdf	Form and Instruction
VA.gov VFS - Searc VA.gov VFS - Search Questionnaire - 01202023 HF VA.gov VFS - Search Questionnaire - 01202023 HF.pdf	Form and Instruction
VA.gov VFS - Searc VA.gov VFS - Search Questionnaire - 01202023 HF VA.gov VFS - Search Questionnaire - 01202023 HF.pdf	Form and Instruction
VA.gov VFS - ChatB VA.gov VFS - ChatBot Questionnaire - 01202023 HF VA.gov VFS - ChatBot Questionnaire - 01202023 HF.pdf	Form and Instruction
VA.gov VFS - ChatB VA.gov VFS - ChatBot Questionnaire - 01202023 HF VA.gov VFS - ChatBot Questionnaire - 01202023 HF.pdf	Form and Instruction
VA.gov A11 Questio VA.gov A11 Questionnaire - 01202023 HF VA.gov A11 Questionnaire - 01202023 HF.pdf	Form and Instruction
VA.gov A11 Questio VA.gov A11 Questionnaire - 01202023 HF VA.gov A11 Questionnaire - 01202023 HF.pdf	Form and Instruction
A-11 Fast-Track Clearance Request VA.gov.pdf A-11 Fast-Track Clearance Request VA.gov	IC Document
A-11 Fast-Track Clearance Request VA.gov.pdf A-11 Fast-Track Clearance Request VA.gov	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

VA.gov A-11 Surveys

Agency IC Tracking Number:

2900-0876 VA.gov A-11 Surveys

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	VA.gov VFS Questionnaire - 01202023 HF	Yes	Yes	Fillable Fileable
Form and Instruction	VA.gov VFS - Search Questionnaire - 01202023 HF	Yes	Yes	Fillable Fileable
Form and Instruction	VA.gov VFS - ChatBot Questionnaire - 01202023 HF	Yes	Yes	Fillable Fileable
Form and Instruction	VA.gov A11 Questionnaire - 01202023 HF	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	300,000	300,000
Annual IC Time Burden (Hours)	15,000	15,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
A-11 Fast-Track Clearance Request VA.gov		02/13/2023

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

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