FS-1800-24 Volunteers Annual Report

USDA Forest Service FS-1800-24 (06/2010)

OMB 0595-0080 (Exp. XX/20XX)

Volunteers Annual Report

Reporting Unit RWU Number or Staff:

     

Reporting Period:

Oct. 1,

     

through Sept. 30,

     

Page

      of      

Name of Volunteer/GROUP

Age Group <18, 18-25, 26-54, 55+

Male Or Female

Ethnicity/Disabled (Use initials; see definitions below)

RESOURCE AREA SUCH AS: RECREATION RESEARCH BUSINESS WILDLIFE

Total Hours

Approx. Grade

$ Value (to be completed by the YVH Coordinator)

(use info from FS-1800-25)

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

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.

Ethnicity: HL (Hispanic or Latino); NHL (Not Hispanic or Latino)

Race: AI/AN (American Indian or Alaska Native); A (Asian); B/AA (Black or African American); NH/PI (Native Hawaiian or other Pacific Islander); W (White) [Choose one or more]

Disabled: D