Information Collection

Annual State Application Under Part B of the Individuals with Disabilities Act as Amended in 2004

IC 188619 under ICR 202210-1820-001 · OMB 1820-0030.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1820-0030 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Annual State Application Under Part B of the Individuals with Disabilities Act as Amended in 2004	Form
1820-0030-PartB-Instruct2023-9-7-22.docx	Instruction
1820-0030-PartB-Instruct2023-9-7-22.docx	Instruction
Significant Disproportionality Reporting Form 1820-0030-Section V.B. - Significant Disproportionality Form (PDF).pdf	Form
Significant Disproportionality Reporting Form 1820-0030-Section V.B. - Significant Disproportionality Form (PDF).pdf	Form
Application 1820-0030-PartB-App2023-9-7-22.docx	Form
Application 1820-0030-PartB-App2023-9-7-22.docx	Form

IC Title:

Annual State Application Under Part B of the Individuals with Disabilities Act as Amended in 2004

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 34 CFR 300.647(b)(1)(i) 34 CFR 300.705 34 CFR 300.640-645 34 CFR 300.646(a)(b) 34 CFR 300.100-176 34 CFR 300.199

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	N/A	Significant Disproportionality Reporting Form	1820-0030-Section V.B. - Significant Disproportionality Form (PDF).pdf	Yes	Yes	Fillable Fileable
Instruction			1820-0030-PartB-Instruct2023-9-7-22.docx	Yes	Yes	Fillable Fileable
Form	N/A	Application	1820-0030-PartB-App2023-9-7-22.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: 60

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	Previously Approved
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	2,340	2,340
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.