Information Collection

Education Stabilization Fund- Elementary and Secondary School Emergency Relief Fund (ESSER I/ESSER II/ARP ESSER Fund) Recipient Data Collection Form

IC 242779 under ICR 202106-1810-006 · OMB 1810-0749.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1810-0749 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Education Stabilization Fund- Elementary and Secondary School Emergency Relief Fund (ESSER I/ESSER II/ARP ESSER Fund) Recipient Data Collection Form	Form
Education Stabilization Fund- Elementary and Secondary S 1810-0749 Revised ESSER Integrated Form 10.26.21.docx	Form
Education Stabilization Fund- Elementary and Secondary S ESSER Integrated Form 12.30.21 (002).docx	Form

IC Title:

Education Stabilization Fund- Elementary and Secondary School Emergency Relief Fund (ESSER I/ESSER II/ARP ESSER Fund) Recipient Data Collection Form

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	N/A	Education Stabilization Fund- Elementary and Secondary School Emergency Relief Fund (ESSER I/ESSER II/ARP ESSER) Recipient Data Collection Form	ESSER Integrated Form 12.30.21 (002).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: 14,652

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 New Statute	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	14,652	0	-4	14,656
Annual IC Time Burden (Hours)	2,051,280	988,860	988,860	73,560
Annual IC Cost Burden (Dollars)	0	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.