View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Medical Foster Home (MFH) Program Veteran & Caregiver Surveys	Agency IC Tracking Number:	VHA-2900-0770

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			MFH Program_Veteran Survey_2021.docx		No		Paper Only
Other-Survey			MFH Program_Caregiver Survey_2021.docx		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,378	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	1,378	0	1,378	0	0	0
Annual IC Time Burden (Hours)	115	0	115	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Supporting Statement - MFH Program Veteran & Caregiver Surveys	Generic Supporting Statement_MFH Program_Veteran & Caregiver Surveys_2021.docx	08/27/2021

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