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Federal forms, ICRs, and supporting documents

Information Collection Request

National Health Survey of Gulf War Era Veterans and Their Families Phase III Physical Examinations

ICR 199807-2900-001 · OMB 2900-0598 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
28835 National Health Survey of Gulf War Era Veterans and Their Families Phase III Physical Examinations Migrated
ICR Details
2900-0598 199807-2900-001
Historical Active
VA
National Health Survey of Gulf War Era Veterans and Their Families Phase III Physical Examinations
New collection (Request for a new OMB Control Number)   No
Emergency 08/15/1998
Approved without change 09/15/1998
Retrieve Notice of Action (NOA) 07/14/1998
Approved for use on an emergency basis through 3/99 under the conditions that: 1)for the public record, VA submits to OMB all revised forms, instructions, and Supporting Statements consistent with commitments made in its 9/9/98 correspondence with the exception of the next two points; 2) VA amends its commitment in Question 1 to clarify that pediatric exams will not be performed in VA hospitals. The original sentence should be revised to account for local medical contacts, i.e. "The examinations will be performed at VA Medical Centers with pediatric contracts from affiliated universities or local medical offices"; 3) consistent with OMB Directive15, VA amends its race/ ethnicity question to include an ethnicity question separate and preliminary to the race question. In addition, in lieu of the "Other (specify)" category, VA should allow respondents to select "one or more" racial categories; and 4) VA provides OMB a more detailed justification of reimbursement, including an explanation of the response rate impacts of alternative lower or higher reimbursements.
  Inventory as of this Action Requested Previously Approved
03/31/1999 03/31/1999
1 0 0
54,920 0 0
0 0 0
Physicians within and outside the VA hospital system will use the information collected during Phase III to aid in diagnosing and treating Gulf War Veterans.
None
None
No
1
IC Title Form No. Form Name
National Health Survey of Gulf War Era Veterans and Their Families Phase III Physical Examinations
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1 0 0 1 0 0
Annual Time Burden (Hours) 54,920 0 0 54,920 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
07/14/1998