Information Collection

Data Collection Form for State Level data request

IC 200101 under ICR 201111-1850-002 · OMB 1850-0884.

Documents and Forms

Document Name Document Type
Att_1850-0884 4718 Appendix D Data Collection FormT06844-AppD.docx Other-Data collection form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Data Collection Form for State Level data request	Agency IC Tracking Number:	4718

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Data collection form			Att_1850-0884 4718 Appendix D Data Collection FormT06844-AppD.docx		No		Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 51	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	51	51
Annual IC Time Burden (Hours)	408	408
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.