Information Collection

NCCC Member Experience Survey

IC 223143 under ICR 201909-3045-008 · OMB 3045-0181.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0181 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 NCCC Member Experience Survey	Form and Instruction
1 NCCC Member Experience Survey Member Experience Survey - For OMB Approval_08-08-2016.pdf www.nationalservice.gov	Form and Instruction
1 NCCC Member Experience Survey 2019.07.01_AmeriCorps NCCC Member Experience Survey_Revised.docx www.nationalservice.gov	Form and Instruction
1 Member Experience Survey AmeriCorps NCCC Member Experience Survey_2019.10.28 Edits.docx www.nationalservice.gov	Form and Instruction

IC Title:

NCCC Member Experience Survey

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	1	Member Experience Survey	AmeriCorps NCCC Member Experience Survey_2019.10.28 Edits.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable
Form and Instruction	1	NCCC Member Experience Survey	Member Experience Survey - For OMB Approval_08-08-2016.pdf	www.nationalservice.gov	Yes	Yes	Fillable Fileable
Form and Instruction	1	NCCC Member Experience Survey	2019.07.01_AmeriCorps NCCC Member Experience Survey_Revised.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: 2,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,000	0	1,550	450
Annual IC Time Burden (Hours)	500	-10	322	188
Annual IC Cost Burden (Dollars)	0	0	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.