Information Collection

Universal Application Revised for SAA 11.13.09

IC 191272 under ICR 201103-3045-002 · OMB 3045-0129.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CNCS_Universal_Application_Revised_3.31.11.doc www.nationalservice.gov	Instruction
Justification_Universal_Application_Revised_3.31.11.doc Justification for Change Request 3.31.11	IC Document
Universal Report Instructions (track changes).doc Tracked changes version for comparison	IC Document

IC Title:

Universal Application Revised for SAA 11.13.09

Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 12501

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
Instruction			CNCS_Universal_Application_Revised_3.31.11.doc	www.nationalservice.gov	Yes	Yes	Fillable Fileable Signable

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 %

table that charts list of burden
	Requested	Previously Approved
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

table that charts IC Documents
Title	Document	Date Uploaded
Justification for Change Request 3.31.11	Justification_Universal_Application_Revised_3.31.11.doc	03/31/2011
Tracked changes version for comparison	Universal Report Instructions (track changes).doc	03/31/2011

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