Information Collection

Martin Luther King Jr. Day of Service Application Instructions

IC 198621 under ICR 201107-3045-005 · OMB 3045-0110.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0110 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Martin Luther King Jr. Day of Service Application Instructions	Form and Instruction
1 MLK Day of Service Application Instructions OMB 12 MLK Application Instructions Final 7.25.11.doc www.nationalservice.gov	Form and Instruction

IC Title:

Martin Luther King Jr. Day of Service Application Instructions

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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
Form and Instruction	1	MLK Day of Service Application Instructions	OMB 12 MLK Application Instructions Final 7.25.11.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: 50

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	500	500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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