Report of Early Intervention Services on IFSPs Provided to Infants, Toddlers, and Their Families in Accordance with Part C and Report of Number and Types of Personnel Employed

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IC Title:	Report of Early Intervention Services on IFSPs Provided to Infants, Toddlers, and Their Families in Accordance with Part C and Report of Number and Types of Personnel Employed	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 57	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 4 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	57	57
Annual IC Time Burden (Hours)	5,187	5,187
Annual IC Cost Burden (Dollars)	0	0

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