Information Collection

Employers of National Service Enrollment Form

IC 219229 under ICR 201512-3045-001 · OMB 3045-0175.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0175 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Employers of National Service Enrollment Form Form and Instruction
1 Employers of National Service Enrollment Form Employers of National Service Member Information Form (Web Form Version).docx www.nationalservice.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Employers of National Service Enrollment Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	1	Employers of National Service Enrollment Form	Employers of National Service Member Information Form (Web Form Version).docx	www.nationalservice.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: 300	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	75	75
Annual IC Cost Burden (Dollars)	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.