Information Collection

AmeriCorps Exit Survey

IC 214239 under ICR 202404-3045-001 · OMB 3045-0094.

Documents and Forms

Document Name Document Type
Form 1 AmeriCorps Exit Survey Form and Instruction
1 AmeriCorps Exit Survey Member Exit Survey_Survey Visual_Word Version_3_15_2024.docx www.nationalservice.gov Form and Instruction
1 AmeriCorps Exit Survey Member Exit Survey_Survey Visual_Word Version_3_15_2024.docx www.nationalservice.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	AmeriCorps Exit Survey	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	1	AmeriCorps Exit Survey	Member Exit Survey_Survey Visual_Word Version_3_15_2024.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: 80,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	80,000	0	80,000
Annual IC Time Burden (Hours)	20,000	0	20,000
Annual IC Cost Burden (Dollars)	1,287,200	1,287,200	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.