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OMB NO. 18200550 Expires: 9/30/2017 ANNUAL STATE APPLICATION UNDER PART C OF THE INDIVIDUALS WITH DISABILITIES EDUCATION ACT AS AMENDED IN 2004 FEDERAL FISCAL YEAR (FLY) 2015 CODA No. 84.181A ED FORM

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OMB No. stands for Office of Management and Budget Number.

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Entities required to submit certain information or reports to the Office of Management and Budget.

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Fill out the required information accurately and submit it to the designated office.

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The purpose is to collect specific information from entities for evaluation and decision-making by the Office of Management and Budget.

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Information required for reporting varies depending on the specific OMB Number assigned to the form.

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