Grantee Reporting Form (JH)

Grantee Reporting Form -RSA Annual Payback Report

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1820-0617 can be found here:

Documents and Forms

Document Name Document Type
Grantee Reporting Form (JH) Form and Instruction
RSA Payback Form RSA grantee payback form.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Grantee Reporting Form (JH)	Agency IC Tracking Number:	03317

Is this a Common Form? No		IC Status: Removed

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
Form and Instruction	NA	RSA Payback Form	RSA grantee payback form.doc		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: 350	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-350	350
Annual IC Time Burden (Hours)	-400	400
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.