Organizational Assessment Form

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⚠️ Notice: This information collection may be referencing outdated material.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 Organizational Assessment Form Form and Instruction
1 CNCS Organizational Assessment Tool CNCS_Organization_Assessment_Tool_Final_082517__508_0.pdf www.nationalservice.gov Form and Instruction
CNCS OCAT Generic Clearance Submission_REVISED.docx OCAT Submission Template IC Document

Information Collection (IC) Details

IC Title:	Organizational Assessment Form	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	CNCS Organizational Assessment Tool	CNCS_Organization_Assessment_Tool_Final_082517__508_0.pdf	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: 100	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OCAT Submission Template	CNCS OCAT Generic Clearance Submission_REVISED.docx	07/20/2018

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