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AmeriCorps State and National Diversity Questionnaire
AmeriCorps State and National Diversity Questionnaire
OMB: 3045-0193
IC ID: 248995
OMB.report
CNCS
OMB 3045-0193
ICR 202108-3045-002
IC 248995
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0193 can be found here:
2022-03-31 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
AmeriCorps State and National Diversity Questionnaire
Form
1 AmeriCorps State and National Diversity Questionnaire
Diversity_Questionnaire_ASN_NOFO_OMB_2021-08-23.xlsx
www.nationalservice.gov
Form
1 AmeriCorps State and National Diversity Questionnaire
Diversity_Questionnaire_ASN_NOFO_OMB_2021-08-23.xlsx
www.nationalservice.gov
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
AmeriCorps State and National Diversity Questionnaire
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
1
AmeriCorps State and National Diversity Questionnaire
Diversity_Questionnaire_ASN_NOFO_OMB_2021-08-23.xlsx
www.nationalservice.gov
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Community and Regional Development
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
750
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
750
0
750
0
0
0
Annual IC Time Burden (Hours)
375
0
375
0
0
0
Annual IC Cost Burden (Dollars)
16,928
0
16,928
0
0
0
Documents for IC
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.