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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
3045-0054
ICR Reference No:
202202-3045-001
Status:
Active
Previous ICR Reference No:
201812-3045-001
Agency/Subagency:
CNCS
Agency Tracking No:
Title:
AmeriCorps Member Application, Enrollment, and Exit Form
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
04/07/2022
Retrieve Notice of Action (NOA)
Date Received in OIRA:
02/09/2022
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
04/30/2025
36 Months From Approved
04/30/2022
Responses
521,000
0
225,000
Time Burden (Hours)
390,750
0
281,250
Cost Burden (Dollars)
12,946,850
0
0
Abstract:
AmeriCorps is soliciting comments concerning its proposed new AmeriCorps Member Application, Enrollment, and Exit Form. Applicants will respond to the questions included in this information collection tool to apply to serve as AmeriCorps members, enroll in the National Service Trust, and exit their term of service.
Authorizing Statute(s):
US Code:
42 USC 12501 et seq
Name of Law: National and Community Service
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
86 FR 68487
12/02/2021
30-day Notice:
Federal Register Citation:
Citation Date:
87 FR 6852
02/07/2022
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
AmeriCorps Member Application
2011-1, SEC -618, 3, 4
Americorps Member Application
,
2011 Member Application
,
AmeriCorps Member Application 12.7.12
,
2015 AmeriCorps Member Application
AmeriCorps Member Application, Enrollment, and Exit Form
2, 1
AmeriCorps Member Application
,
AmeriCorps Enrollment and Exit Form
ICR Summary 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
521,000
225,000
0
296,000
0
0
Annual Time Burden (Hours)
390,750
281,250
0
109,500
0
0
Annual Cost Burden (Dollars)
12,946,850
0
0
12,946,850
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
The burden has increased because we have added the AmeriCorps Enrollment and Exit Forms (former 3045-0006) to this ICR in anticipation of IT modernization which will result in a single form. The burden shows a decrease because we removed the former ICR.
Annual Cost to Federal Government:
$4,315,182
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.
Yes
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.
Yes
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
Agency Contact:
Amy Borgstrom 202 606-6930 aborgstrom@cns.gov
Common Form ICR:
No
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:
02/09/2022
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