Corporation for National Service, Enrollment Form

Corporation for National Service, Enrollment and Exit Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0006 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Corporation for National Service, Enrollment Form Form and Instruction
Additions to AmeriCorps Member Form.docx www.nationalservice.gov Other-Additions to form
1 2014 AC Enrollment Form 20171212 Trust Enrollment Form for CR.docx www.nationalservice.gov Form and Instruction
2 2014 AC Exit Form 20171212 Trust Exit Form for CR.docx www.nationalservice.gov Form and Instruction
20180622 Justification - Nonsubstantive Change OMB.docx Justification for Nonsubstantive Change IC Document

Information Collection (IC) Details

IC Title:	Corporation for National Service, Enrollment Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	1	2014 AC Enrollment Form	20171212 Trust Enrollment Form for CR.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	2	2014 AC Exit Form	20171212 Trust Exit Form for CR.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable Signable
Other-Additions to form			Additions to AmeriCorps Member Form.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title: Corporation-8	FR Citation: 67 FR 4395

Number of Respondents: 269,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 99 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	269,000	109,000	160,000
Annual IC Time Burden (Hours)	44,833	18,166	26,667
Annual IC Cost Burden (Dollars)	2,022,019	2,022,019	0

Documents for IC

Title	Document	Date Uploaded
Justification for Nonsubstantive Change	20180622 Justification - Nonsubstantive Change OMB.docx	06/22/2018

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