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Federal forms, ICRs, and supporting documents

Information Collection Request

Customer Satisfaction Survey for Nutrition and Food Service

ICR 201207-2900-007 · OMB 2900-0227 · Historical Inactive

Forms and Documents
DocumentTypeStatusAvailability
Form VA Form 10-5387 Customer Satisfaction Survey for Nutrition and Food Service Form Unchanged Available
2900-0227_justification[1].docx Supporting Statement A Uploaded 2012-10-22 Available
IC Document Collections
IC IDCollectionTypeStatusForm
44124 Customer Satisfaction Survey for Nutrition and Food Service Form Unchanged
ICR Details
2900-0227 201207-2900-007
Historical Inactive 200907-2900-005
VA 2900-0227
Customer Satisfaction Survey for Nutrition and Food Service
Extension without change of a currently approved collection   No
Regular
Withdrawn and continue 02/22/2013
Retrieve Notice of Action (NOA) 10/22/2012
This collection will be resubmitted under the following control number: 2900-0770.
  Inventory as of this Action Requested Previously Approved
11/30/2012 36 Months From Approved 02/28/2013
125,600 0 125,600
4,187 0 4,187
0 0 0
VA can achieve significant savings through advanced food preparation and advanced food delivery systems. To determine the level of patient satisfaction and quality of services provided, the survey is needed to be performed at the medical centers. The on-going quarterly survey is essential to providing Nutrition and Food Service personnel with reliable, timely information on the quality of food and nutritional services provided to veteran patients.
US Code: 38 USC Section 219 Name of Law: Veterans Benefits
  
None
Not associated with rulemaking
  77 FR 148 08/01/2012
77 FR 203 10/18/2012
No
1
IC Title Form No. Form Name
Customer Satisfaction Survey for Nutrition and Food Service VA Form 10-5387 Customer Satisfaction Survey for Nutrition and Food Service
No
No
$72,597
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Crystal Rennie 202 632-7492 [email protected]
  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.
10/22/2012