Information Collection List

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.
Table 1 Count of Infant and Toddlers Served	Removed	0	0	0	Other-
					Instruction
					Form and Instruction	N/A
					Form and Instruction	N/A
Table 1 RE5 Report of Children Receiving Early Intervention Services in Accordance with Part C	New	56	1836	0	Form and Instruction	N/A
	New	56	1836	0	Form and Instruction	N/A
Table 2 Report of Program Settings Where Early Intervention Services are Provided to Children with Disabilties and Their Families in accordance with Part C	New	56	1336	0	Form and Instruction	N/A
	New	56	1336	0	Form and Instruction	N/A
Table 2 Settings	Removed	0	0	0	Other-
					Instruction
					Form and Instruction	N/A
					Form and Instruction	N/A
Table 3 Exiting	Removed	0	0	0	Other-
					Instruction
					Form and Instruction	N/A
					Form and Instruction	N/A
Table 3 RE5 Report on Infants and Toddlers Exiting Part C	New	56	2815	0	Form and Instruction	N/A
Table 3 RE5 Report on Infants and Toddlers Exiting Part C	New	56	2815	0	Form and Instruction	N/A
Total burden requested under this ICR:		168	5987	0
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