Peace Corps Volunteer Application Form

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
904	Peace Corps Volunteer Application Form Form	Migrated

ICR Details

OMB Control No: 0420-0005	ICR Reference No: 200502-0420-001
Status: Historical Inactive	Previous ICR Reference No: 200202-0420-002
Agency/Subagency: PEACE	Agency Tracking No:
Title: Peace Corps Volunteer Application Form
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted and continue	Conclusion Date: 02/25/2005
	Date Received in OIRA: 02/15/2005
Terms of Clearance: The agency has failed to publish the required Federal Register notices. The 60-day notice published in 2001 was associated with the review of this collection in 2002 and cannot be considered to comply with the requirement for a 60-day notice for this submission. In addition, the agency has not published a 30-day notice announcing submission to OMB. The agency has also failed to comply with the terms of clearance on the prior approval of this collection. These terms of clearance require the agency to revise its race/ethnicity question to conform to OMB's 1997 Statistical Order on the subject and to revise and disclose routine uses of this information under the Privacy Act so as to ensure that the agency discloses information outside of the agency only when the agency deems appropriate and relevant to the purposes for which the information is being gathered. The agency should also review the requirements of Section 7 of the Privacy Act of 1974, which places restrictions and conditions on the mandatory collection of Social Security Number.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2005	02/29/2008	03/31/2006
Responses	30,000	0	30,000
Time Burden (Hours)	240,000	0	0
Cost Burden (Dollars)	104,954,000	0	0

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Abstract: The Peace Corps Volunteer Application form is submitted by all applicants and provides information to staff on the qualifications and suitability for placement of prospective Peace Corps Volunteer applicants.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

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
Peace Corps Volunteer Application Form	PC-1502

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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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: 02/15/2005

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