Information Collection

Survey Questions

IC 196009 under ICR 201101-1076-001 · OMB 1076-0175.

Documents and Forms

Document Name Document Type
Form 1076-0XXX Survey Questions Form and Instruction
1076-0XXX Let's Move! Indian Country - School Survey LMIC_Survey 1 25 11.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Survey Questions	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1076-0XXX	Let's Move! Indian Country - School Survey	LMIC_Survey 1 25 11.pdf		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: 284	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	284	284
Annual IC Time Burden (Hours)	284	284
Annual IC Cost Burden (Dollars)	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.