Teacher Check-in Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0193 can be found here:

Documents and Forms

Document Name Document Type
Teacher Check-in Survey Form and Instruction
Teacher Check-in Survey Teacher Check-In Winter 2021.pdf Form and Instruction
Teacher Check-in Survey Teacher Check-In Winter 2021.pdf Form and Instruction
Teacher survey PRA.pdf Request for Approval IC Document
Teacher survey PRA.pdf Request for Approval IC Document

Information Collection (IC) Details

IC Title:	Teacher Check-in Survey	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Teacher Check-in Survey	Teacher Check-In Winter 2021.pdf		Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title: The Privacy Act of 1974	FR Citation: 85 FR 42966

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	Teacher survey PRA.pdf	04/07/2021

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