Survey Form for the Division of Undergraduate Education Scholarships in Science, Technology, Engineering, and Mathematics (S-STEM) Fellows

EHR Generic Clearance

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3145-0136 can be found here:

Documents and Forms

Document Name Document Type
S-STEM Survey Screenshots.pdf Other-Survey
SupportingStatement.doc S-STEM Supporting Statement IC Document
S-STEM Crosswalk.doc S-STEM Crosswalk IC Document

Information Collection (IC) Details

IC Title:	Survey Form for the Division of Undergraduate Education Scholarships in Science, Technology, Engineering, and Mathematics (S-STEM) Fellows	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			S-STEM Survey Screenshots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	12,000	12,000
Annual IC Time Burden (Hours)	1,000	1,000
Annual IC Cost Burden (Dollars)	120,000	120,000

Documents for IC

Title	Document	Date Uploaded
S-STEM Supporting Statement	SupportingStatement.doc	12/10/2007
S-STEM Crosswalk	S-STEM Crosswalk.doc	12/10/2007

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.