Information Collection

Teacher School Climate & School Safety Survey Abstraction

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

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Teacher School Climate & School Safety Survey Abstraction	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection 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 %

	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

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.