2900-0770 NCA Survey Approval Notice

NOTICE OF OFFICE OF MANAGEMENT AND BUDGET ACTION
Date

12/08/2017

Department of Veterans Affairs

FOR CERTIFYING OFFICIAL:

Scott Blackburn

FOR CLEARANCE OFFICER:

Cynthia Harvey-Pryor

In accordance with the Paperwork Reduction Act, OMB has taken action on your request received
11/30/2017
ACTION REQUESTED: Generic IC
Veterans Experience: NCA Automated Phone Survey
IC TITLE:
ICR REFERENCE NUMBER:

201710-2900-001

AGENCY ICR TRACKING NUMBER:

2900-0770

TITLE:

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCA,
VBA, VHA)
LIST OF INFORMATION COLLECTIONS: See next page
OMB ACTION: Approved without change
OMB CONTROL NUMBER:

2900-0770

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: 09/30/2020

BURDEN:

DISCONTINUE DATE:

RESPONSES

HOURS

COSTS

Previous

335,000

214,167

0

New

335,000

300,000

0

Change due to New Statute

0

0

0

Change due to Agency Discretion

0

85,833

0

Change due to Agency Adjustment

0

0

0

Change due to PRA Violation

0

0

0

Difference

TERMS OF CLEARANCE:

Terms of the Generic ICR remain in effect.

OMB Authorizing Official:

Dominic J. Mancini
Deputy and Acting Administrator,
Office Of Information And Regulatory Affairs

IC Title

Form No.

List of ICs
Form Name

CFR Citation

White House Hotline
Call Center
Email/Survey
Veterans Experience
Agency Priority Goal
(APG) Trust Phone
Survey
Network Consolidated 10-0516
Patient Satisfaction
Laboratory (NCL)
Questionnaire: Network
Phlebotomy Service:
Consolidated Laboratory
Patient Satisfaction
(NCL) Phlebotomy
Questionnaire
Service
Health Advocate Pilot
Project Patient
Satisfaction
Assessment
VISN 1 - Medical Center
Solutions Call Centers
Customer Satisfaction
Survey
VA Pittsburgh
Community Nursing
Home Satisfaction
Survey
Revised VE Outpatient
Survey
SORCC - Veterans
Satisfaction Survey of
Spiritual Care Needs
VEO Disability
Compensation Survey /
VE Outpatient Survey
Questions Non-Sub
Change Request
Veterans Benefits
Administration Veterans
Success on Campus
(VSOC) Survey
Veterans Experience:
NCA Automated Phone
Survey
Total Hours Actually Used for Information Collections Under Currently Approved ICR:

Hrs/$/Resp
67 / 0 / 4,000
250 / 0 / 1,500

431 / 0 / 8,612

13 / 0 / 150

287 / 0 / 4,300

10 / 0 / 120

33 / 0 / 200
7 / 0 / 200
538 / 0 / 32,300

3,333 / 0 / 20,000

180 / 0 / 3,600
5,149