ESI Reporting Tool - Not-For-Profit Institutions

Experimental Sites Initiative Reporting Tool 2017

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1845-0150 can be found here:

Documents and Forms

Document Name Document Type
ESI Reporting Tool - Not-For-Profit Institutions Form and Instruction
ESI Reporting Tool Item Listing December 2017.docx Form and Instruction
New ESI Collection - Revisions - Additional Institutional survey items.docx Form and Instruction

Information Collection (IC) Details

IC Title:	ESI Reporting Tool - Not-For-Profit Institutions	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	N/A	ESI Reporting Tool Item Listing December 2017.docx		Yes	Yes	Fillable Fileable
Form and Instruction	N/A	N/A	New ESI Collection - Revisions - Additional Institutional survey items.docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 43	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	43	43
Annual IC Time Burden (Hours)	774	774
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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