Information Collection

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

IC 188619 under ICR 202508-1820-002 · OMB 1820-0030.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Application Annual State Application Under Part B of the Individuals with Disabilities Act as Amended in 2004	Form
1820-0030-PartB-Instructions-2026.docx	Instruction
1820-0030-PartB-Instructions-2026.docx	Instruction
Application 1820-0030-PartB-App-2026.docx	Form
Application 1820-0030-PartB-App-2026.docx	Form

IC Title:

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 300.199 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

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
Instruction					Yes	Yes	Fillable Fileable
Form	N/A				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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	60	0	60
Annual IC Time Burden (Hours)	840	-1,500	2,340
Annual IC Cost Burden (Dollars)	26,880	26,880	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.

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