Part C Form

IDEIA Part B and C Child Count

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0176 can be found here:

Documents and Forms

Document Name Document Type
Form BIE XXX (To be ass Part C Form Form and Instruction
BIE XXX (To be ass Part C IDEIA Tribal Count Data Requirements (Birth throu Part C Table 1 2.17.11 CLEAN VERSION.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Part C Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BIE XXX (To be assigned upon receipt of OMB No.)	Part C IDEIA Tribal Count Data Requirements (Birth through 2 years)	Part C Table 1 2.17.11 CLEAN VERSION.docx		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: 61	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	61	61
Annual IC Time Burden (Hours)	1,220	1,220
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.