Information Collection

Certification and Agreement for the ESSER Fund Application

IC 241455 under ICR 202008-1810-005 · OMB 1810-0743.

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
1810-new_CARES_ES_IFR_instrument (3).docx	Other-Burden Table
ESSER Fund Certification and Agreement.docx	Form and Instruction

IC Title:

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	N/A	ESSER Fund Certification and Agreement.docx	Yes	Yes	Fillable Fileable
Other-ESSER Clarification			ESSER Clarification for 60 Final (1).pdf	No		Paper Only
Other-Burden Table			1810-new_CARES_ES_IFR_instrument (3).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: 1,952

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	Previously Approved
Annual Number of Responses for this IC	1,952	1,900	52
Annual IC Time Burden (Hours)	76,653	76,393	260
Annual IC Cost Burden (Dollars)	0	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.