Information Collection

Certification and Agreement for the ESSER Fund Application

IC 241455 under ICR 202006-1810-006 · OMB 1810-0743.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1810-0743 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Certification and Agreement for the ESSER Fund Application	Form and Instruction
ESSER Clarification for 60 Final (1).pdf	Other-ESSER Clarification
ESSER Fund Certification and Agreement . clean for OMB.docx	Form and Instruction

IC Title:

Certification and Agreement for the ESSER Fund Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	N/A	N/A	ESSER Fund Certification and Agreement . clean for OMB.docx		Yes	Yes	Fillable Fileable
Other-ESSER Clarification			ESSER Clarification for 60 Final (1).pdf		No		Paper Only

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 52

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	Previously Approved
Annual Number of Responses for this IC	52	52
Annual IC Time Burden (Hours)	260	260
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.