Information Collection

Student - Campus Case

IC 178438 under ICR 201308-0930-001 · OMB 0930-0286.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0286 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Student Instrument Student - Campus Case	Form and Instruction
Student Instrument Student Instruments A11 CCS - Student Instruments.pdf	Form and Instruction
A12 CCS - Student Supporting Documents.pdf Student Supporting Documents	IC Document

IC Title:

Student - Campus Case

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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	Student Instruments	Student Instruments	A11 CCS - Student Instruments.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 288

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-684	684
Annual IC Time Burden (Hours)	-336	336
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Student Supporting Documents	A12 CCS - Student Supporting Documents.pdf	06/03/2010

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