Information Collection

Experimental Sites Data Collection Instrument

IC 207181 under ICR 201507-1845-001 · OMB 1845-0118.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.