Information Collection

38 CFR 77 Report Template

IC 215773 under ICR 201501-2900-009 · OMB 2900-0845.

Documents and Forms

Document Name Document Type
FY15 ASG Quarterly Report - Template.xlsx Quarterly Reporting Measure IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	38 CFR 77 Report Template	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 38 CFR 77

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: Department of Veterans Affairs	FR Citation: 66 FR 63426

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,050	1,050
Annual IC Time Burden (Hours)	2,100	2,100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Quarterly Reporting Measure	FY15 ASG Quarterly Report - Template.xlsx	02/11/2016

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