Information Collection

Certification and Agreement for the ESSER Fund Application

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

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.