Information Collection

Experimental Sites Initiative (ESI) Experiment #4 Survey

IC 222473 under ICR 201510-1845-012 · OMB 1845-0045.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1845-0045 can be found here:

Documents and Forms

Document Name Document Type
Experiment 4 15-16 survey FINAL.doc Other-Survey
Template for Generic Customer Surveys - Experiment 4 FINAL.doc Generic Template IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Experimental Sites Initiative (ESI) Experiment #4 Survey	Agency IC Tracking Number:

IC Status: New

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			Experiment 4 15-16 survey FINAL.doc		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title:	FR Citation:

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

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Template	Template for Generic Customer Surveys - Experiment 4 FINAL.doc	07/14/2016

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