Information Collection

Data Collection Form for State Level data request

IC 200101 under ICR 201111-1850-002 · OMB 1850-0884.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att_1850-0884 4718 Appendix D Data Collection FormT06844-AppD.docx	Other-Data collection form

IC Title:

Agency IC Tracking Number:

4718

Is this a Common Form? No

IC Status: New

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
Other-Data collection form			Att_1850-0884 4718 Appendix D Data Collection FormT06844-AppD.docx		No		Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 51

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	51	51
Annual IC Time Burden (Hours)	408	408
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.