Information Collection

ECCC Vet Center

IC 266009 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⚠️ Notice: This information collection may be referencing outdated material.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:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ECCC Vet Center Wi ECCC Vet Center	Form and Instruction
Form ECCC Vet Center Wi ECCC Vet Center Wireframe ECCC Vet Center	Form and Instruction
ECCC Vet Center Wi ECCC Vet Center Wireframe ECCC Vet Center Wireframe.docx	Form and Instruction
ECCC Vet Center Wi ECCC Vet Center Wireframe ECCC Vet Center Wireframe.docx	Form and Instruction
ICR Template_A11 Section 280 Clearance ECCC Vet Center Survey v2.docx ICR Template_A11 Section 280 Clearance ECCC Vet Center Survey v2	IC Document
ICR Template_A11 Section 280 Clearance ECCC Vet Center Survey v2.docx ICR Template_A11 Section 280 Clearance ECCC Vet Center Survey v2	IC Document

IC Title:

ECCC Vet Center

Agency IC Tracking Number:

ECCC Vet Center 2900-0876

IC Status: Unchanged

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
Form and Instruction	ECCC Vet Center Wireframe				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Veterans, Dependents of Veterans, and Veteran Beneficiaries

FR Citation: 86 FR 6992

Number of Respondents: 15,000

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	15,000	15,000
Annual IC Time Burden (Hours)	1,250	1,250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
ICR Template_A11 Section 280 Clearance ECCC Vet Center Survey v2		03/14/2024

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

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