USDA Forest Service FS-1800-8 (05/2007))
OMB 0596-0080 (Expires 08/2010)
Agreement for Sponsored Voluntary Services
(Public Law 92-300, as amended)
1. Name of Sponsor (Print)
|
|||||||||||
2. Address (Street, City State, Zip Code)
|
|||||||||||
3. We desire to make available the volunteer services of the following person(s) to assist with Forest Service work. (If more space is needed, use reverse)
|
|||||||||||
4. Description of work to be performed:
|
|||||||||||
|
|||||||||||
|
|||||||||||
|
|||||||||||
8. |
|
Is hereby designated to serve as our liaison with the Forest |
|||||||||
|
Service in day-to-day operations under this agreement. |
||||||||||
|
|||||||||||
10. Remarks: (If more space is needed, use reverse)
|
|||||||||||
Signature (Designated Liaison for Sponsored Group/Organization) |
Date |
||||||||||
ACCEPTANCE FOR THE FOREST SERVICE |
|||||||||||
The Forest Service agrees while this agreement is in effect to:
|
|||||||||||
4. Signature
|
5. Title
|
6. Unit
|
7. Date
|
||||||||
Forest Service reimbursement for sponsored participant’s necessary incidental expenses are as follows: |
|||||||||||
a. Subsistence |
Yes |
No |
Amount if yes: |
|
Remarks: |
|
|||||
b. Transportation allowance |
Yes |
No |
Rate if yes: |
|
Remarks: |
|
|||||
c. Provide lodging |
Yes |
No |
Remarks: |
|
|||||||
a. Other |
Yes |
No |
Remarks: |
|
Termination of agreement |
|||||||
1. Agreement Terminated on (Month, Day, Year)
|
2. Signature (Forest Service Officer)
|
||||||
ACCOMPLISHMENTS |
|||||||
Resource Category (a) |
NIRP Code (b) |
Unit of measure (c) |
Amount Accomp. (d) |
Hours Contr. (e) |
Cost to Govt. (f) |
Appraised Value (dollars) (g) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
3. Remarks:
|
Burden Statement
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0596-0080. The time required to complete this information collection is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation, and marital or family status. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at 202-720-2600 (voice and TDD).
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, DC 20250-9410 or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.
Privacy Act Statement
Collection and use is covered by Privacy Act System of Records USDA/OP-1 and is consistent with the provisions of 5 USC 552a (Privacy Act of 1974), which authorizes acceptance of the information requested on this form. The data will be used to maintain official records of volunteers of the USDA Forest Service for the purposes of tort claims and injury compensation. Furnishing this data is voluntary, however if this form is incomplete, enrollment in the program cannot proceed.
File Type | application/msword |
File Title | AGREEMENT FOR INDIVIDUAL VOLUNTARY SERVICES |
Author | FSDefaultUser |
Last Modified By | FSDefaultUser |
File Modified | 2007-06-14 |
File Created | 2007-06-13 |