Information Collection

Individual Childcare Form for Caregiver

IC 179303 under ICR 200703-1850-005 · OMB 1850-0833.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1850-0833 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
6. Individual Child Form for Caregiver_7.17.07.doc	Other-Individual Child Form

IC Title:

Individual Childcare Form for Caregiver

Agency IC Tracking Number:

3222

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Individual Child Form			6. Individual Child Form for Caregiver_7.17.07.doc		No		Paper Only

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 167

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	167	167
Annual IC Time Burden (Hours)	56	56
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.