Information Collection

Survey Questions

IC 196009 under ICR 201101-1076-001 · OMB 1076-0175.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1076-0XXX Let's Move! Indian Country - School Survey Survey Questions	Form and Instruction
1076-0XXX Let's Move! Indian Country - School Survey LMIC_Survey 1 25 11.pdf	Form and Instruction

IC Title:

Survey Questions

Agency IC Tracking Number:

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
Form and Instruction	1076-0XXX				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: 284

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	284	284
Annual IC Time Burden (Hours)	284	284
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.

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