Information Collection

Corporation for National Service, Enrollment Form

IC 29199 under ICR 202007-3045-001 · OMB 3045-0006.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0006 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Corporation for National Service, Enrollment Form	Form and Instruction
Additions to AmeriCorps Member Form.docx www.nationalservice.gov	Other-Additions to form
1 2014 AC Enrollment Form 20171212 Trust Enrollment Form for CR.docx www.nationalservice.gov	Form and Instruction
2 2014 AC Exit Form 20171212 Trust Exit Form for CR.docx www.nationalservice.gov	Form and Instruction
20180622 Justification - Nonsubstantive Change OMB.docx Justification for Nonsubstantive Change	IC Document

IC Title:

Corporation for National Service, Enrollment Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	2014 AC Enrollment Form	20171212 Trust Enrollment Form for CR.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	2	2014 AC Exit Form	20171212 Trust Exit Form for CR.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable Signable
Other-Additions to form			Additions to AmeriCorps Member Form.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: Corporation-8

FR Citation: 67 FR 4395

Number of Respondents: 269,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	269,000	109,000	160,000
Annual IC Time Burden (Hours)	44,833	18,166	26,667
Annual IC Cost Burden (Dollars)	2,022,019	2,022,019	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification for Nonsubstantive Change	20180622 Justification - Nonsubstantive Change OMB.docx	06/22/2018

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