Information Collection

AmeriCorps Community Engagement Survey Instruments

IC 212174 under ICR 201407-3045-001 · OMB 3045-0161.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2 AmeriCorps Community Engagement Survey Instruments	Form and Instruction
1 Operating Site Survey Community Engagement Survey_OperatingSites With PRA_10 7 14.docx www.nationalservice.gov	Form and Instruction
2 Partner Survey Community Engagement Survey_partner survey With PRA_10 7 14.docx www.nationalservice.gov	Form and Instruction
3 Primary Grantee Survey Community Engagement Survey_Grantee WIth PRA_10 7 14.docx www.nationalservice.gov	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 12501 et seq

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	2	Partner Survey	Community Engagement Survey_partner survey With PRA_10 7 14.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable
Form and Instruction	1	Operating Site Survey	Community Engagement Survey_OperatingSites With PRA_10 7 14.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable
Form and Instruction	3	Primary Grantee Survey	Community Engagement Survey_Grantee WIth PRA_10 7 14.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: 1,720

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,720	1,720
Annual IC Time Burden (Hours)	582	582
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.