Information Collection

Education Award Transfer forms

IC 195004 under ICR 201710-3045-001 · OMB 3045-0136.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0136 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Education Award Transfer forms Form and Instruction
1 Transfer Application Form 10Award Transfer Application Form #1_ 06.30.17+.doc my.americorps.gov/mp/login.do Form and Instruction
2 Award Transfer Acceptance Form 10Award Transfer Acceptance Form #3 06.30.17+.doc my.americorps.gov/mp/login.do Form and Instruction
3 Award Transfer Rescind Form Award Transfer Rescind Form wOGC edits.doc my.americorps.gov/mp/login.do Form and Instruction
4 Award Transfer Revoke Form 10Award Transfer Revoke Form #12 06.30.17+.doc my.americorps.gov/mp/login.do Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Education Award Transfer forms	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 12501

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Transfer Application Form	10Award Transfer Application Form #1_ 06.30.17+.doc	https://my.americorps.gov/mp/login.do	Yes	Yes	Fillable Fileable
Form and Instruction	4	Award Transfer Revoke Form	10Award Transfer Revoke Form #12 06.30.17+.doc	https://my.americorps.gov/mp/login.do	Yes	Yes	Fillable Fileable
Form and Instruction	2	Award Transfer Acceptance Form	10Award Transfer Acceptance Form #3 06.30.17+.doc	https://my.americorps.gov/mp/login.do	Yes	Yes	Fillable Fileable
Form and Instruction	3	Award Transfer Rescind Form	Award Transfer Rescind Form wOGC edits.doc	https://my.americorps.gov/mp/login.do	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: 1,420	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	1,420	1,420
Annual IC Time Burden (Hours)	118	118
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.