OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Evaluation of the ESSA Title I, Part D,Neglected or Delinquent Programs

IC 221483 under ICR 201605-1875-003 · OMB 1875-0281.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Appendix A - State Form to List Part D Subgrantee Coordinators Contact Information.docx Other-list of contact Information
Appendix B - State Education Agency (SEA) Coordinator Survey.docx Other-survey
Appendix C - Local Educational Agency (LEA) Coordinator Survey.docx Other-survey
Appendix E - 1) SEA ND Coordinator Protocol.docx Other-protocol
Appendix E - 2) SEA Administrator of Instruction Protocol.docx Other-protocol
Appendix E - 3) SEA Title I Coordinator Protocol.docx Other-protocol
Appendix E - 4) SEA Data Coordinator Protocol.docx Other-protocol
Appendix E - 5) SA Juvenile Justice Agency ND Coordinator Protocol.docx Other-protocol
Appendix E - 6) SA Juvenile Justice Administrator of Instruction Protocol.docx Other-protocol
Appendix E - 7) SA Child Welfare Agency ND Coordinator Protocol.docx Other-protocol
Appendix E - 8) SA Child Welfare Administrator of Instruction Protocol.docx Other-protocol
Appendix E - 9) LEA ND Coordinator Protocol.docx Other-protocol
Appendix E - 11) Local Correctional Facility ND Coordinator Protocol.docx Other-protocol
Appendix E - 10) LEA Administrator of Instruction Protocol.docx Other-protocol
Appendix E - 12) Local Correctional Facility Administrator of Instruction Protocol.docx Other-protocol
Appendix E - 13) Local Correctional Facility Instructional Staff Protocol.docx Other-protocol
Appendix E - 14) Local Child Welfare Program ND Coordinator Protocol.docx Other-protocol
Appendix E - 16) Local Child Welfare Program Instructional Staff Protocol.docx Other-protocol
Appendix E - 15) Local Child Welfare Administrator of Instruction Protocol.docx Other-protocol
Appendix E - 17) Local Facilities & Programs Other Staff Protocol.docx Other-protocol
Appendix F - Request for Documents Form.docx Other-Request form
Appendix C - Local Facility-Program (LFP) Coordinator Survey.docx Other-Survey
Appendix B - State Agency (SA) Coordinator Survey.docx Other-survey

Information Collection (IC) Details

View Information Collection (IC)

layout table

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-list of contact Information Appendix A - State Form to List Part D Subgrantee Coordinators Contact Information.docx Yes Yes Paper Only
Other-survey Appendix B - State Education Agency (SEA) Coordinator Survey.docx Yes No Paper Only
Other-survey Appendix C - Local Educational Agency (LEA) Coordinator Survey.docx Yes No Paper Only
Other-protocol Appendix E - 1) SEA ND Coordinator Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 2) SEA Administrator of Instruction Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 3) SEA Title I Coordinator Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 4) SEA Data Coordinator Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 5) SA Juvenile Justice Agency ND Coordinator Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 6) SA Juvenile Justice Administrator of Instruction Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 7) SA Child Welfare Agency ND Coordinator Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 8) SA Child Welfare Administrator of Instruction Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 9) LEA ND Coordinator Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 11) Local Correctional Facility ND Coordinator Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 10) LEA Administrator of Instruction Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 12) Local Correctional Facility Administrator of Instruction Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 13) Local Correctional Facility Instructional Staff Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 14) Local Child Welfare Program ND Coordinator Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 16) Local Child Welfare Program Instructional Staff Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 15) Local Child Welfare Administrator of Instruction Protocol.docx Yes No Paper Only
Other-protocol Appendix E - 17) Local Facilities & Programs Other Staff Protocol.docx Yes No Paper Only
Other-Request form Appendix F - Request for Documents Form.docx Yes Yes Fillable Fileable
Other-Survey Appendix C - Local Facility-Program (LFP) Coordinator Survey.docx Yes No Paper Only
Other-survey Appendix B - State Agency (SA) Coordinator Survey.docx Yes No Paper Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 554 0 554 0 0 0
Annual IC Time Burden (Hours) 529 0 529 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 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.