Information Collection

VA Cooperative Studies Program (CSP) Customer Satisfaction Survey

IC 211036 under ICR 201403-2900-014 · OMB 2900-0772.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0772 can be found here:

Documents and Forms

Document Name Document Type
Form 10-10074 VA Cooperative Studies Program (CSP) Customer Satisfaction Survey Form and Instruction
10-10074 CSP Customer Satisfaction Survey CSP_Customer Satisfaction Survey0314.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	VA Cooperative Studies Program (CSP) Customer Satisfaction Survey	Agency IC Tracking Number:	10-10074

Is this a Common Form? No		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	10-10074	CSP Customer Satisfaction Survey	CSP_Customer Satisfaction Survey0314.docx		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	83	83
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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