Information Collection

AmeriCorps Member Application

IC 29268 under ICR 201812-3045-001 · OMB 3045-0054.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0054 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SEC -618 AmeriCorps Member Application	Form and Instruction
SEC -618 Americorps Member Application AC Member app Jan 2009.pdf my.americorps.gov/mp/login.do	Form and Instruction
2011-1 2011 Member Application AC Member app Jan 2011.pdf www.nationalservice.gov	Form and Instruction
3 AmeriCorps Member Application 12.7.12 AC Member App Dec 2012 for OIRA.pdf www.nationalservice.gov	Form and Instruction
4 2015 AmeriCorps Member Application Final Cleared AC Member Application 10.6.15.rtf www.nationalservice.gov	Form and Instruction
Comments Received Member Application9.23.15.docx Comments	IC Document

IC Title:

AmeriCorps Member Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	SEC -618	Americorps Member Application	AC Member app Jan 2009.pdf	https://my.americorps.gov/mp/login.do	Yes	Yes	Fillable Fileable
Form and Instruction	2011-1	2011 Member Application	AC Member app Jan 2011.pdf	www.nationalservice.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	3	AmeriCorps Member Application 12.7.12	AC Member App Dec 2012 for OIRA.pdf	www.nationalservice.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	4	2015 AmeriCorps Member Application	Final Cleared AC Member Application 10.6.15.rtf	www.nationalservice.gov	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 225,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	225,000	225,000
Annual IC Time Burden (Hours)	281,250	281,250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Comments	Comments Received Member Application9.23.15.docx	10/02/2015

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