Pilot Test of AmeriCorps Alumni Outcomes Survey

Generic Information Collection Request for Test and Pilot Data

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0163 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Pilot Test of AmeriCorps Alumni Outcomes Survey Form and Instruction
1 Pilot Alumni Survey AmeriCorps Alumni Survey_for Pilot.docx www.nationalservice.gov Form and Instruction
Generic Clearance Submission Template Final_Alumni Outcomes.docx Pilot Alumni Outcomes Generic Submission IC Document

Information Collection (IC) Details

IC Title:	Pilot Test of AmeriCorps Alumni Outcomes 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	Pilot Alumni Survey	AmeriCorps Alumni Survey_for Pilot.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: 75	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	75	75
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Pilot Alumni Outcomes Generic Submission	Generic Clearance Submission Template Final_Alumni Outcomes.docx	11/25/2014

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