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Federal forms, ICRs, and supporting documents

Information Collection Request

Survey of Department of Veterans Affairs (VA) Benefits Usage

ICR 200211-2900-012 · OMB 2900-0611 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
42227 Survey of Department of Veterans Affairs (VA) Benefits Usage Migrated
ICR Details
2900-0611 200211-2900-012
Historical Active 199912-2900-009
VA
Survey of Department of Veterans Affairs (VA) Benefits Usage
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 11/19/2002
Retrieve Notice of Action (NOA) 11/19/2002
  Inventory as of this Action Requested Previously Approved
11/30/2002 11/30/2002 02/28/2003
5,492 0 5,492
2,145 0 2,145
0 0 0
The proposed telephone survey is intended to collect data as a part of a program evaluation to assess the effectiveness and efficiency of VA programs.
None
None
No
1
IC Title Form No. Form Name
Survey of Department of Veterans Affairs (VA) Benefits Usage
  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 5,492 5,492 0 0 0 0
Annual Time Burden (Hours) 2,145 2,145 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
11/19/2002