Information Collection

Segal Education Award Matching Program Commitment Form

IC 202529 under ICR 202409-3045-001 · OMB 3045-0143.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Segal Education Award Matching Program Commitment Form	Form and Instruction
Form 1 Ed Award Commitment Matching Form Segal Education Award Matching Program Commitment Form	Form and Instruction
1 Ed Award Commitment Matching Form SONS Commitment Form 2025.pdf www.nationalservice.gov	Form and Instruction
1 Ed Award Commitment Matching Form SONS Commitment Form 2025.pdf www.nationalservice.gov	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	200	0	200
Annual IC Time Burden (Hours)	100	0	100
Annual IC Cost Burden (Dollars)	6,610	2,096	4,514

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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