Information Collection

Districts/ Student Background Data Request

IC 181150 under ICR 200711-1850-004 · OMB 1850-0839.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Districts/ Student Background Data Request	Form and Instruction
Student Background Data Request Student Background Data Request 6_071.doc	Form and Instruction

IC Title:

Agency IC Tracking Number:

3311

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

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
Form and Instruction	N/A	Student Background Data Request	Student Background Data Request 6_071.doc		No		Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2	2
Annual IC Time Burden (Hours)	30	30
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.