Service Payback Agreement

Indian Education Professional Development Grants Program: GPRA and Service Payback Data Collection

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1810-0698 can be found here:

Documents and Forms

Document Name Document Type
Service Payback Agreement Form
Service Payback Agreement 1810-0698 PD_payback_agreement 04182019.docx Form

Information Collection (IC) Details

IC Title:	Service Payback Agreement	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	N/A	Service Payback Agreement	1810-0698 PD_payback_agreement 04182019.docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 440	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	440	440
Annual IC Time Burden (Hours)	400	400
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.