Information Collection

Campus Health Administrator Assessment

IC 212631 under ICR 201106-1800-002 · OMB 1800-0011.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1800-0011 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Campus Health Administrator Assessment	Form
Campus Health Administrator Assessment 8 8 14 to ED.docx	Form
Att_Generic_Clearance_OMB_Template_Instrument_NEEDS_ASSESSMENTS 8.8.14.docx Att_Generic_Clearance_OMB_Template_Instrument_NEEDS_ASSESSMENTS 8	IC Document

IC Title:

Campus Health Administrator Assessment

Agency IC Tracking Number:

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	N/A	N/A	Campus Health Administrator Assessment 8 8 14 to ED.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: 150

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	150	0	0	0	0	0
Annual IC Time Burden (Hours)	13	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att_Generic_Clearance_OMB_Template_Instrument_NEEDS_ASSESSMENTS 8	Att_Generic_Clearance_OMB_Template_Instrument_NEEDS_ASSESSMENTS 8.8.14.docx	08/11/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.