Information Collection

Teacher School Climate & School Safety Survey Abstraction

IC 222164 under ICR 201606-0930-005 · OMB 0930-0364.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Teacher Survey Dat Teacher School Climate & School Safety Survey Abstraction	Form and Instruction
Teacher Survey Dat Teacher Survey Data Abstraction Attachment 7_Teacher Survey Data Abstraction_03-22-16.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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	Teacher Survey Data Abstraction	Teacher Survey Data Abstraction	Attachment 7_Teacher Survey Data Abstraction_03-22-16.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 125

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	125	125
Annual IC Time Burden (Hours)	188	188
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.