Employers of National Service Enrollment Form and Survey

Forms and Documents

Document Name	Status
Form 1 Employers of National Service Enrollment Form Form and Instruction	Modified
CPO EONS Enrollment and Survey SSA Final.docx Supporting Statement A	2021-06-10

IC Document Collections

IC ID	Document Title	Status
219229	Employers of National Service Enrollment Form Form and Instruction	Modified

ICR Details

OMB Control No: 3045-0175	ICR Reference No: 202106-3045-001
Status: Received in OIRA	Previous ICR Reference No: 201901-3045-001
Agency/Subagency: CNCS	Agency Tracking No:
Title: Employers of National Service Enrollment Form and Survey
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 06/10/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	07/31/2022
Responses	1,180	663
Time Burden (Hours)	492	111
Cost Burden (Dollars)	0	0

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Abstract: CNCS is soliciting comments concerning its proposed Employers of National Service program Enrollment Form and Survey. The Employers of National Service program seeks to connect employers from all sectors with AmeriCorps and Peace Corps alumni.

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Authorizing Statute(s): US Code: 42 USC 12501 Name of Law: National Community Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 14885	03/19/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 30596	06/09/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Employers of National Service Enrollment Form	2, 1, 3	Employers of National Service Enrollment Form ,   Employers of National Service Survey ,   2021 Employers of National Service Survey

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,180	663	0	517	0	0
Annual Time Burden (Hours)	492	111	0	381	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The burden has been adjusted to account for actual usage.

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Annual Cost to Federal Government: $4,717

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/10/2021

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