Longitudinal Research on Member Outcomes

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Contact Information Only Questionnaire	Form and Instruction	New	Available
AC LS OMB Statement Section A.doc	Supporting Statement A	Uploaded 2010-01-11	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
29274	Longitudinal Research on Member Outcomes		Removed
191752	Contact Information Only Questionnaire	Form and Instruction	New

ICR Details

OMB Control No: 3045-0060	ICR Reference No: 200912-3045-002
Status: Historical Active	Previous ICR Reference No: 199908-3045-001
Agency/Subagency: CNCS	Agency Tracking No:
Title: Longitudinal Research on Member Outcomes
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/22/2010
	Date Received in OIRA: 01/11/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2013	36 Months From Approved
Responses	3,320	0	0
Time Burden (Hours)	332	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The Corporation is seeking approval to verify that respondents to the Longitudinal Study of AmeriCorps Members are locatable. The data collection updating will enable the Corporation to continue to track study participants, over the long-term, and reduce study attrition. Members contacted will be assured that they are covered under the Privacy Act and the appropriate Privacy Act statement will be posted upon approval.

---

Authorizing Statute(s): US Code: 42 USC 12501 Name of Law: NCSA
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 53219	10/16/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 1359	01/11/2010
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Contact Information Only Questionnaire	1	AC Longitudinal Contract Info Phone Questionnaire
Longitudinal Research on Member Outcomes

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	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	3,320	0	0	-4,515	0	7,835
Annual Time Burden (Hours)	332	0	0	-2,339	0	2,671
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Forms

Short Statement: Burden is reduced since the questions have been reduced to contact information only.

---

Annual Cost to Federal Government: $75,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 01/11/2010

---