Information Collection

Assessing "Return to Learn" Programs

IC 221572 under ICR 201405-0920-002 · OMB 0920-1009.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1009 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Assessing "Return to Learn" Programs	Form
Return to Learn Assessment Att. B_Instrument__Survey Monkey 2016_5_11.docx	Form
GenIC_Request _RTL EA_2016_5_12.docx Request for Approval	IC Document
Att. A_Announcement_2016_5_12.docx Survey Announcement	IC Document

IC Title:

Assessing "Return to Learn" Programs

Agency IC Tracking Number:

16ALQ

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	none	Return to Learn Assessment	Att. B_Instrument__Survey Monkey 2016_5_11.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	GenIC_Request _RTL EA_2016_5_12.docx	05/18/2016
Survey Announcement	Att. A_Announcement_2016_5_12.docx	05/18/2016

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