Information Collection

Written Application for the Independent Living Services for Older Individuals Who are Blind Formula Grant

IC 21689 under ICR 202305-1820-003 · OMB 1820-0660.

Documents and Forms

Document Name Document Type
Written Application for the Independent Living Services for Older Individuals Who are Blind Formula Grant Form and Instruction
OIB Application Assurances OIB State Assurances 2023 with cover letter-updated 6.5.23.docx Form and Instruction
OIB Application Assurances OIB State Assurances 2023 with cover letter-updated 6.5.23.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Written Application for the Independent Living Services for Older Individuals Who are Blind Formula Grant	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 367.4

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	OIB Application Assurances	OIB State Assurances 2023 with cover letter-updated 6.5.23.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: 19	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	19	-37	56
Annual IC Time Burden (Hours)	3	-6	9
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.