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Forbearance Form
Forbearance Request for National Service Form
OMB: 3045-0030
IC ID: 198535
OMB.report
CNCS
OMB 3045-0030
ICR 202602-3045-002
IC 198535
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
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:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
1
2019 Forbearance
Forbearance Form.docx
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:
CNCS-04-CPO-MPMF-Member Program Management Files
FR Citation:
89 FR 65866
Number of Respondents:
13,182
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
66 %
Requested
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
13,182
0
0
0
0
13,182
Annual IC Time Burden (Hours)
2,197
0
0
0
0
2,197
Annual IC Cost Burden (Dollars)
105,588
0
0
13,578
0
92,010
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.
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