Certification Form for Paperwork Reduction Act for IES MW 4 2 13

Certification for Paperwork Reduction Act Submissions
On behalf of this Federal Agency, I certify that collection of information encompassed by this request complies
with 5 CFR 1320.9 and related provisions of 5 CFR 1320.8(b)(3).
Title(150 characters max):

Impact of an Early Warning and Intervention Monitoring System on Student and School Outcomes

OMB #:

Docket ID# (for office use only):

The following topics summarize the proposed information collection that certification covers. By checking
these boxes and signing below, you are certifying your Principal Office’s compliance. If you are unable to
certify any of these provisions, please identify and explain the reason in number 18 of your accompanying
Supporting Statement:

✔

(a) It is necessary for the proper performance of agency functions;

✔

(b) It avoids unnecessary duplication;

✔

(c) It reduces burden on small entities;

✔

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

✔

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

✔

(f) It indicates the retention periods for recordkeeping requirements;

✔

(g) It informs respondents of the information called for under 5 CFR 1320.8(b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;

✔

(h) It was developed by an office that has planned and allocated resources for the efficient and effective
management and use of the information to be collected;

✔

(i) It uses effective and efficient statistical survey methodology (if applicable);

✔

(j) It makes appropriate use of information technology; and

✔

(k) It reflects appropriate input from all agency offices affected by and involved with collecting required
data from the public.

Your office must certify approval of all submitted information collection requests. Your signature
authorizes RIMS to post the information collection request to EDICSWEB for public comment. If this
collection should not be publicly available, please provide reasons to RIMS via e-mail to
ICDocketMgr@ed.gov with your official EDICS submittal. RIMS does not share Information collections tied
to a proposed or draft rule with the public until the publication date of that rule.

Sue Betka

Digitally signed by Sue Betka
DN: c=US, o=U.S. Government, ou=US Department of
Education, ou=US Department of Education, cn=Sue Betka
Date: 2013.07.19 18:43:34 -04'00'

Digital Signature of Principal Office Official or Designee