Information Collection

Citizen Corps Individual Registration

IC 21175 under ICR 200704-1660-004 · OMB 1660-0099.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0099 can be found here:

Documents and Forms

Document Name Document Type
Citizen Corps Individual Registration Form and Instruction
Subscriber Registration Form CC Subscriber Registration Form.pdf www.citizencorps.gov/citizenCorps/volunteer.do Form and Instruction
Executive Order 13254.pdf Executive Order 13254 IC Document
5 U.S.C. 301.pdf 5 U.S.C. 301 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Citizen Corps Individual Registration	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

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	N/A	Subscriber Registration Form	CC Subscriber Registration Form.pdf	https://www.citizencorps.gov/citizenCorps/volunteer.do	Yes	Yes	Fillable Fileable

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Previously Approved
Annual Number of Responses for this IC	40,000	40,000
Annual IC Time Burden (Hours)	3,333	3,333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Executive Order 13254	Executive Order 13254.pdf	01/29/2002
5 U.S.C. 301	5 U.S.C. 301.pdf	09/29/2006

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.