Employers of National Service Enrollment Form and Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 3 2021 Employers of National Service Survey	Form and Instruction	Modified	Available
Form 2 Employers of National Service Survey	Form and Instruction	Modified	Available
Form 1 Employers of National Service Enrollment Form	Form and Instruction	Modified	Available
Form 1 Employers of National Service Enrollment Form	Form and Instruction	Modified	Repair queued
0175- Nonsub Justification.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-03-26	Available
0175- Nonsub Justification.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-03-26	Repair queued
30-Day Notice EONS.pdf	Supplementary Document	Uploaded 2024-09-25	Available
30-Day Notice EONS.pdf	Supplementary Document	Uploaded 2024-09-25	Missing upstream
60-Day Notice EONS.pdf	Supplementary Document	Uploaded 2024-09-25	Available
60-Day Notice EONS.pdf	Supplementary Document	Uploaded 2024-09-25	Missing upstream
Employers of National Service SSA 2024.docx	Supporting Statement A	Uploaded 2024-09-25	Available
Employers of National Service SSA 2024.docx	Supporting Statement A	Uploaded 2024-09-25	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
219229	Employers of National Service Enrollment Form	Form and Instruction	Modified	2021 Employers of National Service Survey
219229	Employers of National Service Enrollment Form	Form and Instruction	Modified	Employers of National Service Survey
219229	Employers of National Service Enrollment Form	Form and Instruction	Modified	Employers of National Service Enrollment Form
219229	Employers of National Service Enrollment Form	Form and Instruction	Modified

ICR Details

OMB Control No: 3045-0175	ICR Reference No: 202503-3045-003
Status: Active	Previous ICR Reference No: 202408-3045-001
Agency/Subagency: CNCS	Agency Tracking No:
Title: Employers of National Service Enrollment Form and Survey
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/27/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/26/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2027	11/30/2027	11/30/2027
Responses	1,180	0	1,180
Time Burden (Hours)	492	0	492
Cost Burden (Dollars)	21,264	0	21,264

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Abstract: The Employers of National Service program seeks to connect employers from all sectors with AmeriCorps and Peace Corps alumni. This information collection advances that program by including an enrollment form for organizations committed to becoming an Employer of National Service and help connect them to job seekers, and an annual survey form for the organization to share success stories and updates.

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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:
	89 FR 49863	08/20/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 78289	09/25/2024
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

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

table that charts list of burden

	Total Approved	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	1,180	0	0	0	0
Annual Time Burden (Hours)	492	492	0	0	0	0
Annual Cost Burden (Dollars)	21,264	21,264	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $15,411

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: 03/26/2025

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