Information Collection

Potential Adult Student On-line Survey

IC 221902 under ICR 201510-1845-012 · OMB 1845-0045.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1845-0045 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Potential Adult Student On-line Survey	Form and Instruction
Potential Adult College Student Online Survey 2016-06-03.docx	Form and Instruction
OMB Clearance Form Potential Adult College Students Online Survey 6 10 16.doc Generic Template	IC Document

IC Title:

Potential Adult Student On-line Survey

Agency IC Tracking Number:

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 and Instruction	NA	NA	Potential Adult College Student Online Survey 2016-06-03.docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	1	1
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Generic Template	OMB Clearance Form Potential Adult College Students Online Survey 6 10 16.doc	06/13/2016

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