Information Collection

AmeriCorps Exit Survey

IC 214239 under ICR 201412-3045-001 · OMB 3045-0094.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0094 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 AmeriCorps Exit Survey AmeriCorps Exit Survey	Form and Instruction
1 AmeriCorps Exit Survey Exit Survey_12 01 14.docx	Form and Instruction

IC Title:

AmeriCorps Exit Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	1			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: 80,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	80,000	80,000
Annual IC Time Burden (Hours)	20,000	20,000
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.

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