Information Collection

Annual Performance, Financial Need and Certification Report for the Jacob K. Javits Fellowship Program

IC 181775 under ICR 201311-1840-001 · OMB 1840-0630.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
1840-0630_Screenshot_Login_Page_JKJ_APR.doc opeweb.ed.gov/JAVITSAPR	Instruction
1840-0630 1840-0630 Javits APR Form 1840-0630 Javits APR Form.docx opeweb.ed.gov/javitsapr	Form
1840-0630 Javits APR Instructions.docx 1840-0630 Javits APR Instructions	IC Document
1840-0630 Javits APR Att K Sample.xlsx 1840-0630 Javits APR Att K Sample	IC Document
1840-0630 JKJ FAFSA Letter.docx 1840-0630 Javits FAFSA Ltr	IC Document
1840-0630 Javits APR PD Ltr.docx 1840-0630 Javits APR Project Director Letter	IC Document

IC Title:

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 650

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
Instruction			1840-0630_Screenshot_Login_Page_JKJ_APR.doc	https://opeweb.ed.gov/JAVITSAPR	Yes	Yes	Fillable Fileable
Form	1840-0630	1840-0630 Javits APR Form	1840-0630 Javits APR Form.docx	https://opeweb.ed.gov/javitsapr	No	No	Fillable Fileable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 51

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	51	-49	100
Annual IC Time Burden (Hours)	204	-196	400
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
1840-0630 Javits APR Instructions	1840-0630 Javits APR Instructions.docx	08/14/2013
1840-0630 Javits APR Att K Sample	1840-0630 Javits APR Att K Sample.xlsx	08/14/2013
1840-0630 Javits FAFSA Ltr	1840-0630 JKJ FAFSA Letter.docx	08/14/2013
1840-0630 Javits APR Project Director Letter	1840-0630 Javits APR PD Ltr.docx	08/14/2013

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