AmeriCorps Member Application

ICR 201812-3045-001

OMB: 3045-0054

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Justification for No Material/Nonsubstantive Change
2012-12-07
Supplementary Document
2012-12-07
Supporting Statement A
2018-12-13
Justification for No Material/Nonsubstantive Change
2011-01-24
IC Document Collections
IC ID
Document
Title
Status
29268 Modified
ICR Details
3045-0054 201812-3045-001
Active 201510-3045-001
CNCS
AmeriCorps Member Application
Revision of a currently approved collection   No
Regular
Approved without change 02/22/2019
Retrieve Notice of Action (NOA) 12/13/2018
  Inventory as of this Action Requested Previously Approved
02/28/2022 36 Months From Approved 02/28/2019
225,000 0 225,000
281,250 0 281,250
0 0 0

The Corporation is seeking approval of the attached AmeriCorps Member Application. This ICR will enable the public to apply to be AmeriCorps members. The following sentence has been added to the Public Burden and Privacy Statement: The information may be shared with other agencies, such as the Social Security Administration, through computer matching agreements for the purpose of verifying identity and citizenship status information provided by you in your application.

US Code: 42 USC 12501 et seq Name of Law: National and Community Service
  
None

Not associated with rulemaking

  83 FR 49550 10/02/2018
83 FR 63846 12/12/2018
No

1
IC Title Form No. Form Name
AmeriCorps Member Application 2011-1, SEC -618, 3, 4 Americorps Member Application ,   2011 Member Application ,   AmeriCorps Member Application 12.7.12 ,   2015 AmeriCorps Member Application

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 225,000 225,000 0 0 0 0
Annual Time Burden (Hours) 281,250 281,250 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
    Yes
    Yes
No
No
No
Uncollected
Amy Borgstrom 202 606-6930 aborgstrom@cns.gov

  No

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.
12/13/2018


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