Information Collection

Beneficiary Travel Self Service System (BTSSS) Survey Question updates

IC 272500 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⚠️ Notice: This information collection may be referencing outdated material.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
BTSSS_Change Request.docx	Other-Survey Instrument
BTSSS_Change Request.docx	Other-Survey Instrument
ICR Template_A11 Section 280 Clearance BTSSS Change Request.docx ICR A-11 Section 280 BTSSS Change Request Cover Sheet	IC Document
ICR Template_A11 Section 280 Clearance BTSSS Change Request.docx ICR A-11 Section 280 BTSSS Change Request Cover Sheet	IC Document
Beneficiary Travel Self Service System (BTSSS) Sampling Plan updated.docx BTSSS Sample Plan	IC Document
Beneficiary Travel Self Service System (BTSSS) Sampling Plan updated.docx BTSSS Sample Plan	IC Document

IC Title:

Beneficiary Travel Self Service System (BTSSS) Survey Question updates

Agency IC Tracking Number:

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
Other-Survey Instrument					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: 156,000

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	156,000	156,000
Annual IC Time Burden (Hours)	13,000	13,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
ICR A-11 Section 280 BTSSS Change Request Cover Sheet		12/03/2024
BTSSS Sample Plan		12/03/2024

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].