Peace Corps Medical Clearance Survey

Peace Corps Medical Clearance Study

Documents and Forms

Document Name Document Type
Zoomerang MCS edited for PRA submission.doc Other-Survey

Information Collection (IC) Details

IC Title:	Peace Corps Medical Clearance Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Other-Survey			Zoomerang MCS edited for PRA submission.doc		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: PC-19 Office of Inspector General Investigative Records	FR Citation: 22 FR 308

Number of Respondents: 1,673	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 78 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,673	1,673
Annual IC Time Burden (Hours)	697	697
Annual IC Cost Burden (Dollars)	0	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.