AmeriCorps Member Application, Enrollment, and Exit Form

ICR 202202-3045-001

OMB: 3045-0054

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Removed
Form and Instruction
New
Supplementary Document
2022-02-09
Justification for No Material/Nonsubstantive Change
2012-12-07
Supplementary Document
2012-12-07
Supporting Statement A
2022-02-09
Justification for No Material/Nonsubstantive Change
2011-01-24
ICR Details
3045-0054 202202-3045-001
Received in OIRA 201812-3045-001
CNCS
AmeriCorps Member Application, Enrollment, and Exit Form
Revision of a currently approved collection   No
Regular 02/09/2022
  Requested Previously Approved
36 Months From Approved 02/28/2022
521,000 225,000
390,750 281,250
12,946,850 0

AmeriCorps is soliciting comments concerning its proposed new AmeriCorps Member Application, Enrollment, and Exit Form. Applicants will respond to the questions included in this information collection tool to apply to serve as AmeriCorps members, enroll in the National Service Trust, and exit their term of service.

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

Not associated with rulemaking

  86 FR 68487 12/02/2021
87 FR 6852 02/07/2022
No

  Total Request 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 521,000 225,000 0 296,000 0 0
Annual Time Burden (Hours) 390,750 281,250 0 109,500 0 0
Annual Cost Burden (Dollars) 12,946,850 0 0 12,946,850 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
The burden has increased because we have added the AmeriCorps Enrollment and Exit Forms (former 3045-0006) to this ICR in anticipation of IT modernization which will result in a single form. The burden shows a decrease because we removed the former ICR.

$4,315,182
No
    Yes
    Yes
No
No
No
No
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.
02/09/2022


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