ICR/OIRA Conclusion 201012-2900-007

View ICR - OIRA Conclusion
OMB Control No : 2900-0782
ICR Reference No : 201012-2900-007
Status : Historical Active
Previous ICR Reference No :
Agency/Subagency : VA
Agency Tracking No :
Title : VOV (Voice of Veteran) Surveys
Type of Information Collection : New collection (Request for a new OMB Control Number)
Type of Review Request : Regular
Requested Expiration Date :
Date Received in OIRA:
OIRA Conclusion Action:

36 Months From
Approved
04/21/2011

Approved Expiration Date:

Approved with change Conclusion Date:

07/31/2015
07/09/2012

Please see NOA at last page
Terms of Clearance:
By the time of the next submission, VA will provide an assessment of whether the items that are unrelated to
customer satisfaction are necessary/appropriate in this set of surveys, and a re-assessment of whether any of the
items can be obtained from administrative data.

Abstract:
VOV (Voice of Veteran) Surveys will be used primarily to measure customer satisfaction from the veterans and their
dependents.

Authorizing Statute(s):
Citations for New Statutory Requirements :
None

Associated Rulemaking Information :
RIN :
Stage of Rulemaking :

Federal Register Citation :

Date :

Not associated with
rulemaking

Federal Register Notices & Comments :
60-day Notice:
Federal Register Citation:
76 FR 15

30-day Notice:

Federal Register Citation:
76 FR 71

Did the Agency receive public comments on this ICR ?
Number of Information Collection( IC ) in this ICR :
ICR Summary of Burden
Total
Approved

Citation Date:
01/24/2011

Citation Date:
04/13/2011

No

1

Previously
Change
Change Due Change Due
Change Due to
Approved Due to New to Agency to Adjustment Potential Violation
Statute
Discretion
in Estimate
of the PRA

View ICR - OIRA Conclusion
Total
Approved
Annual
Number of
Responses
Annual Time
Burden (Hr)
Annual Cost
Burden ($)

Previously
Change
Change Due Change Due
Change Due to
Approved Due to New to Agency to Adjustment Potential Violation
Statute
Discretion
in Estimate
of the PRA

30,000

0

0

30,000

0

0

7,500

0

0

7,500

0

0

0

0

0

0

0

0

Burden increases because of Program Change due to Agency Discretion :
Burden Increase Due to : Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion :
Burden Reduction Due to :
Short Statement :

Yes
No

New Data Collection.

Annual cost to the Federal Government : $1,001,885
Does this IC contains surveys, censuses or employ statistical methods ?

Yes Part B of Supporting
Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the
E-Government Act 2002 ? No
Is this ICR related to the Affordable Care Act ? No
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Is this ICR related to a guidance document ? No
Agency Contact : Denise McLamb 202 632-7479 denise.mclamb@va.gov
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:
(a)It is necessary for the proper performance of agency functions;
(b)It avoids unnecessary duplication;
(c)It reduces burden on small entities;
(d)It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e)Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f)It indicates the retention periods for recordkeeping requirements;
(g)It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h)It was developed by an office that has planned and allocated resources for the efficient and effective management
and use of the information to be collected.
(i)It uses effective and efficient statistical survey methodology (if applicable); and
(j)It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item(s) and explain the reason in the
Supporting Statement.

Certification Date :

04/21/2011

View ICR - OIRA Conclusion
Certifying Official
APC:

McLamb, Denise 202 632-7479 ext. denise.mclamb@va.

On Behalf of:

Baker, Roger 202 461-6911 roger.baker2@va.gov

Sign-Off History
Sign-Off From
Dooling, Bridget

Action Date
07/09/2012

Action

Sign-Off To

Approved with change Malanoski, Margaret

Notes
#

OMB Control No :

ICR Ref No. :

ICR Expiration Date :

ICR Status :

2900-0782

201012-2900-007

07/31/2015

Historical Active

Agency/SubAgency : Agency Tracking No : Title : VOV (Voice of Veteran) Surveys
VA

Request Status :

Last Event :

Last Event User :

Last Event Date :

Approved

Superseded [by]

Dooling, Bridget

01/24/2014

View IC
IC Title : VOV (Voice of Veteran) Surveys

Agency IC Tracking Number :

No
Is this a Common Form?
Obligation to Respond : Voluntary
CFR Citation :
Information Collection Instruments :

IC Status : New

Instrument
File
VBA_Comp_S
ervicing
questionnaire_
7.2.12.final.doc
x
VBA_CP_Enro
llment
questionnaire_
7.2.12.final.doc
x
VBA_EDU_Enr
ollment
questionnaire_
7.2.12.final.doc
x
VBA_EDU_Ser
vicing
questionnaire_
7.2.12.final.doc
x
VBA_LGY_Enr
ollment
questionnaire_
7.2.12.final.doc
x
VBA_Pens_Se
rvicing
questionnaire_
7.2.12.final.doc
x
VBA_SAH_Ser
vicing
questionnaire_
7.2.12.final.doc
x

Form No.

Form Name Document
Type

URL

Available
Can be
Electronic
Electronicall Submitted Capability
y?
Electronicall

Other - Comp
Servicing
Questionnaire

Yes

Yes

Fillable
Fileable

Other Compensation
& Pension
Enrollment
questionnaire
Other - EDU
enrollment
Questionnaire

Yes

Yes

Fillable
Fileable

Yes

Yes

Fillable
Fileable

Other - EDU
Servicing
Questionnaire

Yes

Yes

Fillable
Fileable

Other - LGY
Enrollment
questionnaire

Yes

Yes

Fillable
Fileable

Other Pens_Servicin
g
questionnaire

Yes

Yes

Fillable
Fileable

Other SAH_Servicing
questionnaire

Yes

Yes

Fillable
Fileable

Instrument
File

Form No.

Form Name Document
Type

VBA_VRE_Enr
ollment
questionnaire_
7.2.12.final.doc
x
VBA_VRE_Es
caped
Beneficiary
questionnaire_
7.2.12.final.doc
x
VBA_VRE_Ser
vicing
questionnaire
7.2.12.final.doc
x

URL

Available
Can be
Electronic
Electronicall Submitted Capability
y?
Electronicall

Other - VRE
Enrollment
questionnaire

Yes

Yes

Fillable
Fileable

Other - VRE
Escaped
Beneficiary
questionnaire

Yes

Yes

Fillable
Fileable

Other - VRE
Servicing
questionnaire

Yes

Yes

Fillable
Fileable

Federal Enterprise Architecture Business Reference Model
Line of Business : General Government
SubFunction : Central Records & Statistical Mgt
Privacy Act System of Records
Title :
30000
Number of Respondents :
Affected Public : Individuals or

FR Citation :
0

Number of Respondents for Small Entity :

Households

Percentage of Respondents Reporting Electronically :
Annual IC Burden :
Approved

Annual Number
of Responses for
this IC
Annual IC Time
Burden (Hours)
Annual IC Cost
Burden (Dollars)

10%

Program
Program
Change Due Change Due
to New Statue to Agency

Change Due Change Due
to Adjustment to Potential
in Agency
Violation

Previously
Approved

30,000

0

30,000

0

0

0

7,500

0

7,500

0

0

0

0

0

0

0

0

0

OMB Control No :

ICR Ref No. :

ICR Expiration Date :

ICR Status :

2900-0782

201012-2900-007

07/31/2015

Historical Active

Agency/SubAgency : Agency Tracking No : Title : VOV (Voice of Veteran) Surveys
VA

Request Status :

Last Event :

Last Event User :

Last Event Date :

Approved

Superseded [by]

Dooling, Bridget

01/24/2014

View ICR Documents

Supporting Statement A
Document

Version

Date Uploaded

Uploaded By

VOV_Supporting Statement
A_6 25 12.docx
VOV justification.docx

2.0

07/05/2012

Mclamb, Denise

1.0

04/21/2011

Mclamb, Denise

Document

Version

Date Uploaded

Uploaded By

VOV_Supporting Statement
B_6 28 12.docx
Part B Supporting
Statement_VOV Pilot_12 09
10.doc

2.0

07/05/2012

Mclamb, Denise

1.0

12/09/2010

Bolyard, Dottie

Supporting Statement B

Supplementary Documents
Title

Document

Comp_Enrollment
Cover Letter

Comp_Enrollment_Cov Supplementary
er_Letter_4 26
Document
11_clean.doc
Comp_Enrollment_Post Supplementary
card_4 26 11_clean.doc Document
VBA_Analytic
Supplementary
Map_C&P
Document
Enrollment_06.27.final.x
lsx
VBA_Analytic
Supplementary
Map_Compensation
Document
Servicing_06.27.12.final
.xlsx
VBA_Analytic
Supplementary
Map_Education
Document
Enrollment_06.27.12.fin
al.xlsx
VBA_Analytic
Supplementary
Map_Education
Document
Servicing_06.27.12.final
.xlsx

Comp
Enrollment_Postcard
Analytic Map - C&P
Enrollment
Analytic Map Compensation
Servicing
Analytic Map Education Enrollment
Analytic Map Education Servicing

Document Type

Date Uploaded

Uploaded By

07/09/2012

Dooling, Bridget

07/09/2012

Dooling, Bridget

07/09/2012

Dooling, Bridget

07/09/2012

Dooling, Bridget

07/09/2012

Dooling, Bridget

07/09/2012

Dooling, Bridget

Analytic Map - LGY
Enrollment

VBA_Analytic
Supplementary
Map_LGY
Document
Enrollment_06.27.12
final.xlsx
Analytic Map - Pension VBA_Analytic
Supplementary
Servicing
Map_Pension
Document
Servicing_06.27.12.final
.xlsx
Analytic Map - SAH
VBA_Analytic
Supplementary
Servicing
Map_SAH
Document
Servicing_06.27.12.final
.xlsx
Analytic Map - VR&E VBA_Analytic
Supplementary
Escaped Beneficiary
Map_VR&E Escaped Document
Beneficiary_06.27.12.fin
al.xlsx
Analytic Map - VR&E VBA_Analytic
Supplementary
Enrollment
Map_VRE Enrollment_6 Document
27 12.final.xlsx
Analytic Map - VR&E VBA_Analytic
Supplementary
Servicing
Map_VRE Servicing_06 Document
27 12_final.xlsx
VOV Benchmark
VBA_VOV Benchmark Supplementary
Overview
Overview_OMB
Document
Response_6.7.12.xlsx

07/09/2012

Dooling, Bridget

07/09/2012

Dooling, Bridget

07/09/2012

Dooling, Bridget

07/09/2012

Dooling, Bridget

07/09/2012

Dooling, Bridget

07/09/2012

Dooling, Bridget

07/09/2012

Dooling, Bridget

NOTICE OF OFFICE OF MANAGEMENT AND BUDGET ACTION
Date

07/09/2012

Department of Veterans Affairs

FOR CERTIFYING OFFICIAL:

Roger Baker

FOR CLEARANCE OFFICER:

Denise McLamb

In accordance with the Paperwork Reduction Act, OMB has taken action on your request received
04/21/2011
ACTION REQUESTED:

New collection (Request for a new OMB Control Number)

TYPE OF REVIEW REQUESTED:

Regular

ICR REFERENCE NUMBER:

201012-2900-007

AGENCY ICR TRACKING NUMBER:
TITLE:

VOV (Voice of Veteran) Surveys

LIST OF INFORMATION COLLECTIONS: See next page
OMB ACTION: Approved with change
OMB CONTROL NUMBER:

2900-0782

The agency is required to display the OMB Control Number and inform respondents of its legal significance in
accordance with 5 CFR 1320.5(b).
EXPIRATION DATE: 07/31/2015

BURDEN:

DISCONTINUE DATE:

RESPONSES

HOURS

COSTS

0

0

0

30,000

7,500

0

0

0

0

30,000

7,500

0

Change due to Agency Adjustment

0

0

0

Change due to PRA Violation

0

0

0

Previous
New
Difference
Change due to New Statute
Change due to Agency Discretion

TERMS OF CLEARANCE:

By the time of the next submission, VA will provide an assessment of whether the items that
are unrelated to customer satisfaction are necessary/appropriate in this set of surveys, and a
re-assessment of whether any of the items can be obtained from administrative data.

OMB Authorizing Official:

Kevin F. Neyland
Deputy Administrator,
Office Of Information And Regulatory Affairs

List of ICs
IC Title
VOV (Voice of Veteran)
Surveys

Form No.

Form Name

CFR Citation