Information Collection

Corporation for National Service EXIT FORM

IC 29212 under ICR 200704-3045-005 · OMB 3045-0015.

Documents and Forms

Document Name Document Type
Form 3045-0015 Corporation for National Service EXIT FORM Form and Instruction
3045-0015 MeMber Exit Form rev ameriC exit frm.pdf www.cns.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Corporation for National Service EXIT FORM	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	3045-0015	MeMber Exit Form	rev ameriC exit frm.pdf	www.cns.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: 146,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 99 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	146,000	96,000	50,000
Annual IC Time Burden (Hours)	8,517	2,684	5,833
Annual IC Cost Burden (Dollars)	0	0	0

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.