Survey of Veteran Enrollees -Quality and Efficiency of VA Health Care

ICR 200807-2900-001

OMB: 2900-0725

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
New
Supplementary Document
2009-03-27
Supporting Statement A
2008-10-23
IC Document Collections
ICR Details
2900-0725 200807-2900-001
Historical Active
VA
Survey of Veteran Enrollees -Quality and Efficiency of VA Health Care
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 03/30/2009
Retrieve Notice of Action (NOA) 10/23/2008
Approved consistent with changes outlined in VA memo submitted to OMB.
  Inventory as of this Action Requested Previously Approved
03/31/2012 36 Months From Approved
80,080 0 0
18,133 0 0
0 0 0

By way of Presidential Executive Order 13410 (08/22/06), Section 1,

US Code: 38 USC 527 Name of Law: Evaluation and data collection
   EO: EO 13410 Name/Subject of EO: Help Increase the Transparency of America's Health Care System
  
None

Not associated with rulemaking

  73 FR 151 08/05/2008
73 FR 204 10/21/2008
No

1
IC Title Form No. Form Name
Survey of Veteran Enrollees Quality and Efficiency of VA Health Care VA Form 10-21088 Survey of Veteran Enrollees - Quality and Efficiency of VA Health Care

  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 80,080 0 0 80,080 0 0
Annual Time Burden (Hours) 18,133 0 0 18,133 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new collection and all burden hours are considered a program change.

$656,740
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Denise McLamb 202-565-8374 denise.mclamb@mail.va.gov

  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.
10/23/2008


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