Universal Application Revised for SAA 11.13.09

CNCS Universal Application

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0129 can be found here:

Documents and Forms

Document Name Document Type
CNCS Universal Application Revised 11.13.09.doc www.nationalservice.gov Instruction
Justification Universal Application Revised 11.13.09.doc Justification for Non-Substantive Change IC Document

Information Collection (IC) Details

IC Title:	Universal Application Revised for SAA 11.13.09	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 12501

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			CNCS Universal Application Revised 11.13.09.doc	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:	FR Citation:

Number of Respondents: 2,200	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,200	2,200
Annual IC Time Burden (Hours)	17,600	17,600
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Justification for Non-Substantive Change	Justification Universal Application Revised 11.13.09.doc	11/13/2009

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