Louis Stokes Alliances for Minority Participation Monitoring System (LSAMP)

EHR Generic Clearance

Documents and Forms

Document Name Document Type
2011_LSAMP_AppendixA_Screenshots_20110705.doc Other-Survey
2011_LSAMP_AppendixB_Crosswalk_20110107.doc LSAMP Monitoring System Crosswalk IC Document
2011_LSAMP_AppendixC_SampleCorrespondence_20110107.doc LSAMP Monitoring System Sample Correspondence IC Document
2011_LSAMP_SupportingStatement.doc LSAMP Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	Louis Stokes Alliances for Minority Participation Monitoring System (LSAMP)	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			2011_LSAMP_AppendixA_Screenshots_20110705.doc		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 529	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	529	529
Annual IC Time Burden (Hours)	13,754	13,754
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
LSAMP Monitoring System Crosswalk	2011_LSAMP_AppendixB_Crosswalk_20110107.doc	03/03/2011
LSAMP Monitoring System Sample Correspondence	2011_LSAMP_AppendixC_SampleCorrespondence_20110107.doc	03/03/2011
LSAMP Supporting Statement	2011_LSAMP_SupportingStatement.doc	07/08/2011

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