Information Collection

Surveys and Administrative Records Collection

IC 234837 under ICR 201902-1850-001 · OMB 1850-0948.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Surveys and Administrative Records Collection	Form and Instruction
App A State Survey Appendix A State Survey.docx	Form and Instruction
App B Provider Survey Appendix B Provider Survey.docx	Form and Instruction
App C Provider List Appendix C Provider List Final.docx	Form and Instruction
Appendix D Contact Materials Final.docx App D Contact Materials	IC Document

IC Title:

Agency IC Tracking Number:

ED-2019-ICCD-0011

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	App A State Survey	Appendix A State Survey.docx	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	App B Provider Survey	Appendix B Provider Survey.docx	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	App C Provider List	Appendix C Provider List Final.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: 1,859

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

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	620	620
Annual IC Time Burden (Hours)	310	310
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
App D Contact Materials	Appendix D Contact Materials Final.docx	05/30/2019

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