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Federal forms, ICRs, and supporting documents

Information Collection

Blind and Low Vision Rehabilitation Survey

IC 268074 under ICR 202503-2900-010 · OMB 2900-0876.

Documents and Forms
Document Name
Document Type
Other-Survey Instrument
Other-Survey Instrument
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Blind and Low Vision Rehabilitation Survey 2900-0876
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey Instrument Blind Rehab Wireframe.docx Yes Yes Fillable Fileable

Health Health Care Services

Veterans, Dependents of Veterans, and Veteran Beneficiaries  86 FR 6992

18,000 0
   
Individuals or Households
 
   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 18,000 0 0 0 0 18,000
Annual IC Time Burden (Hours) 1,500 0 0 0 0 1,500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Blind and Low Vision Rehab Survey Cover sheet ICR Template_A11 Section 280 Clearance 8 16 23.docx 05/30/2024
Blind and Low Vision Rehab Survey Sample Plan Blind Rehabilitation Services sample plan final.docx 05/30/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.