Information Collection

Grantee Reporting Form (JH)

IC 21609 under ICR 200908-1820-009 · OMB 1820-0617.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1820-0617 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Grantee Reporting Form (JH)	Form and Instruction
RSA Payback Form RSA grantee payback form.doc	Form and Instruction

IC Title:

Grantee Reporting Form (JH)

Agency IC Tracking Number:

03317

Is this a Common Form? No

IC Status: Removed

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	RSA Payback Form	RSA grantee payback form.doc		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 350

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-350	350
Annual IC Time Burden (Hours)	-400	400
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.