Information Collection

AmeriCorps*National Civilian Community Corps Service Project Application

IC 42254 under ICR 201302-3045-002 · OMB 3045-0010.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0010 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 AmeriCorps*National Civilian Community Corps Service Project Application	Form and Instruction
1 NCCC Project Sponsor application DH Draft5 3-08-13 - NCCC Project Sponsor Application.doc www.nationalservice.gov	Form and Instruction
Citation authorization.doc Authorizing Statute	IC Document

IC Title:

AmeriCorps*National Civilian Community Corps Service Project Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 12612

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	NCCC Project Sponsor application	DH Draft5 3-08-13 - NCCC Project Sponsor Application.doc	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: 1,200

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,200	0	1,200
Annual IC Time Burden (Hours)	9,000	600	8,400
Annual IC Cost Burden (Dollars)	150,857	0	150,857

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Authorizing Statute	Citation authorization.doc	01/31/2007

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