Information Collection

VA Calls Backs

IC 232457 under ICR 202504-0925-001 · OMB 0925-0208.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 VA Calls Backs	Form
Form 1 VA Call Backs VA Calls Backs	Form
1 VA Call Backs Appendix 1E VA Follow Up Calls.docx	Form
1 VA Call Backs Appendix 1E VA Follow Up Calls.docx	Form

IC Title:

VA Calls Backs

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	1				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-25-0156, âRecords of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service

FR Citation: 67 FR 60742

Number of Respondents: 26,055

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	26,055	26,055
Annual IC Time Burden (Hours)	1,737	1,737
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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