Cooperative Studies Program (CSP): Site Survey and Meeting Evaluation

Forms and Documents

Document Name	Status
Form 10-10074a VA Cooperative Studies Program (CSP) Meeting Evaluation Form and Instruction	Modified
Form 10-10074 VA Cooperative Studies Program (CSP) Customer Satisfaction Survey Form and Instruction	Modified
30 Day FRN - Published.pdf Supplementary Document	2018-04-05
60 Day FRN - Published.pdf Supplementary Document	2018-01-17
CSP_Survey Justification A_2900-0772_Extension.docx Supporting Statement A	2018-04-10

IC Document Collections

IC ID	Document Title	Status
211037	VA Cooperative Studies Program (CSP) Meeting Evaluation Form and Instruction	Modified
211036	VA Cooperative Studies Program (CSP) Customer Satisfaction Survey Form and Instruction	Modified

ICR Details

OMB Control No: 2900-0772	ICR Reference No: 201709-2900-017
Status: Active	Previous ICR Reference No: 201505-2900-005
Agency/Subagency: VA	Agency Tracking No: 2900-0772
Title: Cooperative Studies Program (CSP): Site Survey and Meeting Evaluation
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/25/2018
	Date Received in OIRA: 04/10/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2021	36 Months From Approved
Responses	1,000	0	0
Time Burden (Hours)	166	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The information collected will be used by VA Cooperative Studies Program (CSP) leadership to evaluate their Coordinating Centers' effectiveness in conducting meetings and interacting with participating study sites and other customers.

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Authorizing Statute(s): US Code: 38 USC Part 1, Chapter 5, Section 527 Name of Law: Evaluation and Data Collection
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 51482	11/06/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 3258	01/23/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
VA Cooperative Studies Program (CSP) Meeting Evaluation	10-10074a	CSP Meeting Evaluation
VA Cooperative Studies Program (CSP) Customer Satisfaction Survey	10-10074	CSP Customer Satisfaction Survey

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ICR Summary of Burden

	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	1,000	0	0	0	0	1,000
Annual Time Burden (Hours)	166	0	0	0	0	166
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $3,550

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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 by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/10/2018

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