Information Collection

Survey of SRSA Grantees and RLIS Subgrantee Districts

IC 212874 under ICR 201408-1875-002 · OMB 1875-0274.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
TO10 State REAP Coordinator Data CollectionRequest AppendixF_140908b.docx	Other-data collection request
REAP App A district Post-Pilot Survey 08-22-14.docx	Other-survey

IC Title:

Agency IC Tracking Number:

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 request			TO10 State REAP Coordinator Data CollectionRequest AppendixF_140908b.docx		Yes	Yes	Fillable Fileable
Other-survey			REAP App A district Post-Pilot Survey 08-22-14.docx		No		Paper Only

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

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	300	300
Annual IC Time Burden (Hours)	158	158
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.