Information Collection

Forbearance Form

IC 198535 under ICR 202301-3045-003 · OMB 3045-0030.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0030 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Forbearance Form	Form and Instruction
Form 1 2019 Forbearance Forbearance Form	Form and Instruction
1 2019 Forbearance 2016 Forbearance with AC watermark 20191226.docx	Form and Instruction
1 2019 Forbearance 2016 Forbearance with AC watermark 20191226.docx	Form and Instruction

IC Title:

Forbearance 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			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: Member Management Files

FR Citation: 67 FR 4395

Number of Respondents: 13,182

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 66 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	13,182	2,182	11,000
Annual IC Time Burden (Hours)	2,197	364	1,833
Annual IC Cost Burden (Dollars)	92,010	92,010	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.

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