Experimental Sites Data Collection Instrument

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1845-0118 can be found here:

Documents and Forms

Document Name Document Type
Experimental Sites Data Collection Instrument Form and Instruction
ESI Data Collection Instrument ESI new template mock up 2015-07-01.pdf expeirmentalsites.ed.gov Form and Instruction
PRA_Burden_Statement[1].doc PRA_Burden_Statement[1] IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Experimental Sites Data Collection Instrument	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 1094a (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	ESI Data Collection Instrument	ESI new template mock up 2015-07-01.pdf	https://expeirmentalsites.ed.gov	Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11	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 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	9	-16	25
Annual IC Time Burden (Hours)	54	-221	275
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
PRA_Burden_Statement[1]	PRA_Burden_Statement[1].doc	05/29/2013

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