Information Collection

Case Service Report (RSA-911)

IC 186855 under ICR 202303-1820-005 · OMB 1820-0508.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1820-0508 can be found here:

Documents and Forms

Document Name Document Type
Form 911 Case Service Report (RSA-911) Form and Instruction
Paperwork Burden Statement (RSA-911 06.27.23).docx Other-Paperwork Burden Statement
Paperwork Burden Statement (RSA-911 06.27.23).docx Other-Paperwork Burden Statement
911 Reporting Tool for the Case Service Report (RSA-911) RSA-911 (30 Day Notice 06.27.23).xlsx Form and Instruction
911 Reporting Tool for the Case Service Report (RSA-911) RSA-911 (30 Day Notice 06.27.23).xlsx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Case Service Report (RSA-911)	Agency IC Tracking Number:	ED-2018-ICCD-0100

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 34 CFR 361

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	911	Reporting Tool for the Case Service Report (RSA-911)	RSA-911 (30 Day Notice 06.27.23).xlsx		Yes	Yes	Fillable Fileable
Other-Paperwork Burden Statement			Paperwork Burden Statement (RSA-911 06.27.23).docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title: RSA-911 Case Service Report	FR Citation: 85 FR 46075

Number of Respondents: 78	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	312	0	312
Annual IC Time Burden (Hours)	12,236,731	12,202,285	34,446
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.