Forbearance Request for National Service Form

Forms and Documents

Document Name	Status
Form 1 Forbearance Request for National Service Form Form and Instruction	Removed
Form 2 Forbearance Form--Institution Section Form and Instruction	New
Form 1 Forbearance Form--Student Section Form and Instruction	New
Justification - Forbearance 9.14.11 - 2.doc Supporting Statement A	2011-09-14

IC Document Collections

IC ID	Document Title	Status
42257	Forbearance Request for National Service Form Form and Instruction	Removed
199211	Forbearance Form--Institution Section Form and Instruction	New
198535	Forbearance Form--Student Section Form and Instruction	New

ICR Details

OMB Control No: 3045-0030	ICR Reference No: 201107-3045-003
Status: Historical Active	Previous ICR Reference No: 200807-3045-001
Agency/Subagency: CNCS	Agency Tracking No:
Title: Forbearance Request for National Service Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/04/2011
	Date Received in OIRA: 07/19/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2014	36 Months From Approved	10/31/2011
Responses	8,000	0	11,000
Time Burden (Hours)	667	0	1,833
Cost Burden (Dollars)	0	0	0

---

Abstract: This form, or its electronic equivalent, is used by AmeriCorps members to request a forbearance based on national service, and by schools and lenders to verify eligibility for the forbearance, and by both parties to verify certain legal requirements.

---

Authorizing Statute(s): US Code: 42 USC 12602-12604 Name of Law: National and Community Service Act, as amended
  

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:
	76 FR 25673	05/05/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 41769	07/15/2011
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Forbearance Form--Institution Section	2	Forbearance Form--Institution Section
Forbearance Form--Student Section	1	Forbearance Form--Student Section
Forbearance Request for National Service Form	1, 2	Forbearance Form- Paper Version ,   Forbearance Form- Electronic Version

---

ICR Summary 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	8,000	11,000	0	-11,000	8,000	0
Annual Time Burden (Hours)	667	1,833	0	-1,833	667	0
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: Miscellaneous Actions

Short Statement: The burden for this ICR has decreased because we have a more accurate estimate of how many students and institutions use the electronic and paper forms.

---

Annual Cost to Federal Government:

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]? 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: 07/19/2011

---