AmeriCorps Diversity Questionnaire

Forms and Documents

Document Name	Status
Form 1 AmeriCorps Diversity Questionnaire Form	Modified
30-Day Notice.pdf Supplementary Document	2022-03-31
60-Day Notice.pdf Supplementary Document	2022-03-31
DVSA Authority for Diversity Questionnaire_p 24.pdf Supplementary Document	2022-03-24
NCSA_Authority for Diversity Questionnaire pp 85 101 103.pdf Supplementary Document	2022-03-24
Diversity Questionnaire Justification SSA 31March2022.docx Supporting Statement A	2022-03-31

IC Document Collections

IC ID	Document Title	Status
248995	AmeriCorps Diversity Questionnaire Form	Modified

ICR Details

OMB Control No: 3045-0193	ICR Reference No: 202203-3045-001
Status: Received in OIRA	Previous ICR Reference No: 202108-3045-002
Agency/Subagency: CNCS	Agency Tracking No:
Title: AmeriCorps Diversity Questionnaire
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 03/31/2022

	Requested	Previously Approved
Expiration Date	36 Months From Approved	03/31/2022
Responses	3,350	750
Time Burden (Hours)	16,750	375
Cost Burden (Dollars)	0	16,928

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Abstract: The information collected will provide AmeriCorps with data to inform strategies to create programs that represent and serve the full diversity of the nation’s communities, including supporting the advancement of representative leadership and supporting grantees whose leadership represents its community. The information collected will enable AmeriCorps to make inform funding decisions, lead targeted trainings, provide inclusive technical assistance, and conduct outreach to potential grantees that represent and serve the full diversity of our nation’s communities.

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Authorizing Statute(s): US Code: 42 USC 4950 et seq. Name of Law: Domestic Volunteer Service Act
   US Code: 42 USC 12501 et seq. Name of Law: National and Community Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 2145	01/13/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 18773	03/31/2022
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
AmeriCorps Diversity Questionnaire	1	AmeriCorps Diversity Questionnaire

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	3,350	750	0	2,600	0	0
Annual Time Burden (Hours)	16,750	375	0	13,000	3,375	0
Annual Cost Burden (Dollars)	0	16,928	0	0	-16,928	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: AmeriCorps made program changes to expand the scope of respondents to include not only organizations seeking ASN resources, but also applicants and grantees of the VISTA, NCCC, and ACS programs, in order to obtain this information across the agencies’ programs. In response to public comment, AmeriCorps also made changes to the estimates for how long it takes respondents to fulfill the information collection to account for both the time it takes to actually fill in the form and the time it takes to collect the information needed to fill in the form. These changes resulted in an increase in responses of 2,600 and an increase in burden hours of 16,375.

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Annual Cost to Federal Government: $103,824

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/31/2022

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