Information Collection

Education Award Transfer forms

IC 195004 under ICR 202011-3045-001 · OMB 3045-0136.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0136 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Education Award Transfer forms	Form and Instruction
1 Transfer Application Form 10Award Transfer Application Form #1_ 06.30.17+.doc my.americorps.gov/mp/login.do	Form and Instruction
1 Transfer Application Form 10Award Transfer Application Form #1_ 06.30.17+.doc my.americorps.gov/mp/login.do	Form and Instruction
2 Award Transfer Acceptance Form 10Award Transfer Acceptance Form #3 06.30.17+.doc my.americorps.gov/mp/login.do	Form and Instruction
2 Award Transfer Acceptance Form 10Award Transfer Acceptance Form #3 06.30.17+.doc my.americorps.gov/mp/login.do	Form and Instruction
3 Award Transfer Rescind Form Award Transfer Rescind Form wOGC edits.doc my.americorps.gov/mp/login.do	Form and Instruction
3 Award Transfer Rescind Form Award Transfer Rescind Form wOGC edits.doc my.americorps.gov/mp/login.do	Form and Instruction
4 Award Transfer Revoke Form 10Award Transfer Revoke Form #12 06.30.17+.doc my.americorps.gov/mp/login.do	Form and Instruction
4 Award Transfer Revoke Form 10Award Transfer Revoke Form #12 06.30.17+.doc my.americorps.gov/mp/login.do	Form and Instruction

IC Title:

Education Award Transfer forms

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 12501

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	Transfer Application Form	10Award Transfer Application Form #1_ 06.30.17+.doc	https://my.americorps.gov/mp/login.do	Yes	Yes	Fillable Fileable
Form and Instruction	2	Award Transfer Acceptance Form	10Award Transfer Acceptance Form #3 06.30.17+.doc	https://my.americorps.gov/mp/login.do	Yes	Yes	Fillable Fileable
Form and Instruction	3	Award Transfer Rescind Form	Award Transfer Rescind Form wOGC edits.doc	https://my.americorps.gov/mp/login.do	Yes	Yes	Fillable Fileable
Form and Instruction	4	Award Transfer Revoke Form	10Award Transfer Revoke Form #12 06.30.17+.doc	https://my.americorps.gov/mp/login.do	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: 900

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	900	-520	0	1,420
Annual IC Time Burden (Hours)	75	-43	0	118
Annual IC Cost Burden (Dollars)	0	4,182	-4,182	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.