Information Collection

Citizen Corps Individual Registration

IC 21175 under ICR 200609-1660-004 · OMB 1660-0078.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Citizen Corps Individual Registration	Form and Instruction
Subscriber Registration Form CC Subscriber Registration Form.pdf www.citizencorps.gov/citizenCorps/volunteer.do	Form and Instruction
Executive Order 13254.pdf Executive Order 13254	IC Document
5 U.S.C. 301.pdf 5 U.S.C. 301	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Subscriber Registration Form	CC Subscriber Registration Form.pdf	https://www.citizencorps.gov/citizenCorps/volunteer.do	Yes	Yes	Fillable Fileable

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	40,000	40,000
Annual IC Time Burden (Hours)	3,333	3,333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Executive Order 13254	Executive Order 13254.pdf	09/27/2006
5 U.S.C. 301	5 U.S.C. 301.pdf	09/27/2006

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