Information Collection

AmeriCorps Diversity Questionnaire

IC 248995 under ICR 202203-3045-001 · OMB 3045-0193.

Documents and Forms

Document Name Document Type
Form 1 AmeriCorps Diversity Questionnaire Form
1 AmeriCorps Diversity Questionnaire Diversity_Questionnaire_Collection_FINAL_31March2022.xlsx www.nationalservice.gov Form
1 AmeriCorps Diversity Questionnaire Diversity_Questionnaire_Collection_FINAL_31March2022.xlsx www.nationalservice.gov Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	AmeriCorps Diversity Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	AmeriCorps Diversity Questionnaire	Diversity_Questionnaire_Collection_FINAL_31March2022.xlsx	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: 3,350	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,350	2,600	0	750
Annual IC Time Burden (Hours)	16,750	13,000	3,375	375
Annual IC Cost Burden (Dollars)	0	0	-16,928	16,928

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.