OMB
.report
Search
Military Exposure Survey
Clearance for A-11 Section 280 Improving Customer Experience Information Collection
OMB: 2900-0876
IC ID: 259032
OMB.report
VA
OMB 2900-0876
ICR 202503-2900-010
IC 259032
( )
Documents and Forms
Document Name
Document Type
Form Military Exposures
Military Exposure Survey
Form and Instruction
Form Military Exposures
Military Exposure Survey
Form and Instruction
Military Exposures Military Exposures Care Survey 2023_03_06
Military Exposures Care Survey 2023_03_06.pdf
Form and Instruction
Military Exposures Military Exposures Care Survey 2023_03_06
Military Exposures Care Survey 2023_03_06.pdf
Form and Instruction
A-11 Fast-Track Clearance Request Template_Military Exposure.pdf
A-11 Fast-Track Clearance Request Template_Military Exposure
IC Document
A-11 Fast-Track Clearance Request Template_Military Exposure.pdf
A-11 Fast-Track Clearance Request Template_Military Exposure
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Military Exposure Survey
Agency IC Tracking Number:
Military Exposure Survey 2900-0876
IC Status:
Unchanged
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
Military Exposures Care Survey 2023_03_06
Military Exposures Care Survey 2023_03_06
Military Exposures Care Survey 2023_03_06.pdf
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:
120,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
120,000
0
0
0
0
120,000
Annual IC Time Burden (Hours)
10,000
0
0
0
0
10,000
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
A-11 Fast-Track Clearance Request Template_Military Exposure
A-11 Fast-Track Clearance Request Template_Military Exposure.pdf
03/09/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.