AmeriCorps State and National Diversity Questionnaire

Forms and Documents

Document Name	Status
Form 1 AmeriCorps State and National Diversity Questionnaire Form	New
ARP See pp. 34-45 for Authorizing Language.pdf Supplementary Document	2021-08-24
ASN Diversity Questionnaire Authorizing Language.pdf Supplementary Document	2021-08-24
Supporting_Statement_for_PRA_Submissions_AmeriCorpsDiversityQuestionnaire_2021-08-24.docx Supporting Statement A	2021-08-24

IC Document Collections

IC ID	Document Title	Status
248995	AmeriCorps State and National Diversity Questionnaire Form	New

ICR Details

OMB Control No:	ICR Reference No: 202108-3045-002
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: CNCS	Agency Tracking No:
Title: AmeriCorps State and National Diversity Questionnaire
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 09/24/2021
Date Submitted to OIRA: 08/24/2021

	Requested	Previously Approved
Expiration Date	6 Months From Approved
Responses	750	0
Time Burden (Hours)	375	0
Cost Burden (Dollars)	16,928	0

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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.

Emergency Justfication: AmeriCorps State and National cannot meet the 60-30-day Paperwork Reduction Act (PRA) clearance timeline for our Diversity Questionnaire instrument due to our grantmaking timelines; however, we agree to participate in the 30-day public comment period as part of this emergency request and agree to resubmit this package for the full 60-30-day PRA clearance timeline as soon as our emergency request is approved. Our grantmaking involves direct grantmaking and partnering with State Commissions who manage their own grantmaking process. AmeriCorps will release the FY 2022 AmeriCorps State and National Grants Notice of Funding Opportunity (NOFO) and associated documents (including this Diversity Questionnaire instrument) to the public on the target date of September 9, 2021. Two weeks prior to the public NOFO release, AmeriCorps State and Nationals shares the NOFO and associated documents with State Commissions in an embargoed format, so each state can create their own NOFOs consistent with state rules and regulations. State Commissions are responsible for two thirds of the applicants that come in to our competitive process. After these two weeks, AmeriCorps releases the ASN NOFO and associated documents to the public and State Commissions release their similar NOFOs to their respective states. All applicants get the NOFO information at the same time – National Directs and Single State Applicants (who apply to State Commissions). State Commissions are responsible for running a complete grant process before they submit their applications to AmeriCorps. Thus, while our AmeriCorps’ application deadline is in early January 2022, most State Commissions’ deadlines are in the Fall of 2021. State Commissions have the remainder of 2021 to review the information, provide technical assistance, and determine which of the Single State Applicants they will send on to AmeriCorps in January 2022. Public harm is reasonably likely to occur if normal clearance procedures are followed as AmeriCorps State and National will not be able to collect this required information as part of the upcoming grant applications and therefore will not be able to implement the components of the American Rescue Plan Act. If State Commissions do not have access to this Diversity Questionnaire instrument at the NOFO release on the target of September 9, 2021 or shortly afterwards, it lessens/eliminates the chance that AmeriCorps will have access to this information from Single State Applicants which make up two thirds of our portfolio. Additionally, the Diversity Questionnaire instrument is necessary to make data-informed decisions that enable AmeriCorps to 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. Without this information, AmeriCorps will not be able to advance representative leadership and support grantees whose leadership represents its community or be compliant with the American Rescue Plan Act.

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Authorizing Statute(s): US Code: 42 USC 12639 Name of Law: National 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
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 47301	08/24/2021
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
AmeriCorps State and National Diversity Questionnaire	1	AmeriCorps State and National 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	750	0	0	750	0	0
Annual Time Burden (Hours)	375	0	0	375	0	0
Annual Cost Burden (Dollars)	16,928	0	0	16,928	0	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: Net burden has increased because this is a new information collection.

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Annual Cost to Federal Government: $8,463

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: 08/24/2021

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