Community Awareness of AmeriCorps Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0137 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Community Awareness of AmeriCorps Survey Form and Instruction
1 Community Awareness Survey Community Awareness Survey.docx www.nationalservice.gov Form and Instruction
Generic Clearance Submission_Community_Awareness_Clearance.docx Community Awareness Survey Submission Template IC Document

Information Collection (IC) Details

IC Title:	Community Awareness of AmeriCorps Survey	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Community Awareness Survey	Community Awareness Survey.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	21	21
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Community Awareness Survey Submission Template	Generic Clearance Submission_Community_Awareness_Clearance.docx	02/11/2015

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