This information
collection request is approved on the conditions agreed to by CNCS
in their 11/22/2000 memo. CNCS must provide OMB with a revised copy
of the Exit form that reflects the new language requested by the
OIG regarding penalties for false statements and certification of
hours of service.
Inventory as of this Action
Requested
Previously Approved
11/30/2003
11/30/2003
11/30/2000
48,000
0
31,000
5,600
0
5,683
0
0
0
The Corporation for National Service's
Exist Form is used by AmeriCorps programs to provide information
regarding an AmeriCorps member's term of national service. The form
is used by a member's program to indicate whether the member is
eligible for an education award. Members use the form to update
their addresses in the Corporation's databse and to indicate their
desire to be contacted by organizations after they complete their
service.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.