AmeriCorps Member Feedback Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Performance Measurement in AmeriCorps: Surveys of Members, Former Members and Organizations	Form and Instruction	Removed	Repair queued
Form 1 AmeriCorps Member Survey	Form and Instruction	New	Available
OMB Justification 3045-0094 Part B 5.27.11.doc	Supporting Statement B	Uploaded 2011-05-31	Available
OMB Justification 3045-0094 Part A 5.27.11.doc	Supporting Statement A	Uploaded 2011-05-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
42275	Performance Measurement in AmeriCorps: Surveys of Members, Former Members and Organizations	Form and Instruction	Removed
197923	AmeriCorps Member Survey	Form and Instruction	New

ICR Details

OMB Control No: 3045-0094	ICR Reference No: 201105-3045-003
Status: Historical Active	Previous ICR Reference No: 200711-3045-001
Agency/Subagency: CNCS	Agency Tracking No:
Title: AmeriCorps Member Feedback Survey
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/27/2011
	Date Received in OIRA: 05/31/2011
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2014	36 Months From Approved	07/31/2011
Responses	170,000	0	69,000
Time Burden (Hours)	28,333	0	11,500
Cost Burden (Dollars)	0	0	210,184,615

---

Abstract: The primary purpose of the AmeriCorps' Member Feedback Survey is to provide reliable and valid outcome data on members' AmeriCorps experience. As part of this effort, all exiting AmeriCorps members are surveyed regarding their service experience with AmeriCorps State and National, AmeriCorps VISTA, and the AmeriCorps National Civilian Community Corps' (NCCC). Information captured in these surveys helps inform policy decisions and the management of AmeriCorps' National Service Programs, as well as help guide the development of the support provided to members and national service organizations

---

Authorizing Statute(s): US Code: 42 USC 12501 Name of Law: NAtional and Community Service
  

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:
	75 FR 78682	12/16/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 23998	04/29/2011
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
Performance Measurement in AmeriCorps: Surveys of Members, Former Members and Organizations	NA, NA, NA, NA	NA ,   NA ,   NA ,   NA
AmeriCorps Member Survey	1	AmeriCorps Member Survey

---

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	170,000	69,000	0	101,000	0	0
Annual Time Burden (Hours)	28,333	11,500	0	16,833	0	0
Annual Cost Burden (Dollars)	0	210,184,615	0	-210,184,615	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: Miscellaneous Actions

Short Statement: The burden has increased because more members enroll in AmeriCorps each year. We expect 115,000 respondents in the frist year, 140,000 in the second, and 170,000 in the third. Total respondents has been averaged over the three years that this information will be collected.

---

Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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: 05/31/2011

---