View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	30820 Q VAMyHealtheVet Mobile_1-5-2022 by Chris Nelson	Agency IC Tracking Number:	30820 Q VAMyHealtheVet Mobile_1-5-2022 by Chris Ne

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
Form and Instruction	30820 Q VAMyHealtheVet Mobile_1-5-2022 by Chris Ne	30820 Q VAMyHealtheVet Mobile_1-5-2022 by Chris Nelson	30820 Q VAMyHealtheVet Mobile_1-5-2022 by Chris Nelson.xlsx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	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	24,000	0	24,000	0	0	0
Annual IC Time Burden (Hours)	1,200	0	1,200	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
1090-0008 Generic Clearance Request Form MyHealtheVet Mobile Jan 07 2022	1090-0008 Generic Clearance Request Form MyHealtheVet Mobile Jan 07 2022.pdf	01/28/2022
Survey Mapping Document (VHA) IA 30820 Mobile Jan 07 2022	Survey Mapping Document (VHA) IA 30820 Mobile Jan 07 2022.xlsx	01/28/2022

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