Information Collection

COVID-19 Symptom Tracker -- Students

IC 244484 under ICR 202011-1205-002 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachments A and B Sympton Tracker and Emotional Wellness Checklist Forms 112320.docx	Other-Checklist
Attachments A and B Sympton Tracker and Emotional Wellness Checklist Forms 112320.docx	Other-Checklist

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

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
Other-Checklist			Attachments A and B Sympton Tracker and Emotional Wellness Checklist Forms 112320.docx		No		Paper Only

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,640,000	3,640,000
Annual IC Time Burden (Hours)	120,120	120,120
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.