Employment Verification Form

Indian Education Professional Development Grants Program: GPRA and Service Payback Data Collection

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1810-0698 can be found here:

Documents and Forms

Document Name Document Type
Employment Verification Form Form and Instruction
IE PD Employment Verification Form and Instructs 1810-0698 IE PD Employment Verifi Form Ins.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Employment Verification Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 34 CFR 263

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	IE PD Employment Verification Form and Instructs	1810-0698 IE PD Employment Verifi Form Ins.doc		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title: Indian Education Individual Reporting on Regulatory Compliance Related to the Indian Education Professional Development programs Service Obligation and GPRA	FR Citation: 76 FR 4334

Number of Respondents: 1,020	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,020	1,020
Annual IC Time Burden (Hours)	1,020	1,020
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.