Information Collection

Application for Department of Defense Impact Aid for Children with Severe Disabilities

IC 5521 under ICR 200608-0704-004 · OMB 0704-0425.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0425 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Secretary of Defen Application for Department of Defense Impact Aid for Children with Severe Disabilities	Form
0704-0425 Atch C-2 Excel Version SD 816 fY06 DRAFT.xls	Other-Excel Version of SD Form 816
0704-0425 Atch C-4 Excel Version SD 816 C fy06 DRAFT.xls	Other-Excel Version of SD Form 816C
Secretary of Defen Application for Department of Defense Impact Aid for Chi 0704-0425 Atch C-1 sd0816.pdf	Form
Secretary of Defen Application for Department of Defense Impact Aid for Chi 0704-0425 Atch C-3 sd0816c.pdf	Form
0704-0425 Atch C-5 DUSD(MC&FP) Draft Ltr to Superintendents.doc DUSD(MC&FP) Draft Letter to Superintendents	IC Document
0704-0425 Atch C-6 to Draft DUSD Ltr FY06 Guidelines for LEAs - Severe Disabilities DRAFT.doc Draft DUSD Letter FY06 Guidelines for LEAs	IC Document
0704-0425 Atch C-7 NCES CCD Finance Data FY06 DRAFT.xls NCES CCD Finance Data FY06 Draft	IC Document
0704-0425 Signed 83-I.pdf 0704-0425 Signed 83-I.pdf	IC Document

IC Title:

Application for Department of Defense Impact Aid for Children with Severe Disabilities

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Secretary of Defense Form 816	Application for Department of Defense Impact Aid for Children with Severe Disabilities	0704-0425 Atch C-1 sd0816.pdf	Yes	Yes	Fillable Fileable
Form	Secretary of Defense Form 816-C	Application for Department of Defense Impact Aid for Children with Severe Disabilities (Continuation Page)	0704-0425 Atch C-3 sd0816c.pdf	Yes	Yes	Fillable Fileable
Other-Excel Version of SD Form 816			0704-0425 Atch C-2 Excel Version SD 816 fY06 DRAFT.xls	Yes	Yes	Fillable Fileable
Other-Excel Version of SD Form 816C			0704-0425 Atch C-4 Excel Version SD 816 C fy06 DRAFT.xls	Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	50	0	50
Annual IC Time Burden (Hours)	400	0	400
Annual IC Cost Burden (Dollars)	11,712	11,712	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
DUSD(MC&FP) Draft Letter to Superintendents	0704-0425 Atch C-5 DUSD(MC&FP) Draft Ltr to Superintendents.doc	08/31/2006
Draft DUSD Letter FY06 Guidelines for LEAs	0704-0425 Atch C-6 to Draft DUSD Ltr FY06 Guidelines for LEAs - Severe Disabilities DRAFT.doc	08/31/2006
NCES CCD Finance Data FY06 Draft	0704-0425 Atch C-7 NCES CCD Finance Data FY06 DRAFT.xls	08/31/2006
0704-0425 Signed 83-I.pdf	0704-0425 Signed 83-I.pdf	08/31/2006

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