Information Collection

AmeriCorps Member Application

IC 29268 under ICR 201212-3045-001 · OMB 3045-0054.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0054 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SEC -618 AmeriCorps Member Application	Form and Instruction
SEC -618 Americorps Member Application AC Member app Jan 2009.pdf my.americorps.gov/mp/login.do	Form and Instruction
2011-1 2011 Member Application AC Member app Jan 2011.pdf www.nationalservice.gov	Form and Instruction
3 AmeriCorps Member Application 12.7.12 AC Member App Dec 2012 for OIRA.pdf www.nationalservice.gov	Form and Instruction

IC Title:

AmeriCorps Member Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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	SEC -618	Americorps Member Application	AC Member app Jan 2009.pdf	https://my.americorps.gov/mp/login.do	Yes	Yes	Fillable Fileable
Form and Instruction	2011-1	2011 Member Application	AC Member app Jan 2011.pdf	www.nationalservice.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	3	AmeriCorps Member Application 12.7.12	AC Member App Dec 2012 for OIRA.pdf	www.nationalservice.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 225,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	225,000	225,000
Annual IC Time Burden (Hours)	337,500	337,500
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.