Information Collection

Voucher and Payment Request Form

IC 42256 under ICR 202301-3045-002 · OMB 3045-0014.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0014 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Voucher and Payment Request Form Form and Instruction
1 2016 Voucher and Payment Request Form 2016 Manual voucher May 23 2016 OGC - FINAL - OGC edit.doc www.nationalservice.gov Form and Instruction
1 2016 Voucher and Payment Request Form 2016 Manual voucher May 23 2016 OGC - FINAL - OGC edit.doc www.nationalservice.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Voucher and Payment Request Form	Agency IC Tracking Number:	N/A

Is this a Common Form? No		IC Status: Modified

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 and Instruction	1	2016 Voucher and Payment Request Form	2016 Manual voucher May 23 2016 OGC - FINAL - OGC edit.doc	www.nationalservice.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title: Member Management Files	FR Citation: 67 FR 4395

Number of Respondents: 34,385	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 66 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	34,385	-127,615	162,000
Annual IC Time Burden (Hours)	2,865	-10,635	13,500
Annual IC Cost Burden (Dollars)	120,004	120,004	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.