Information Collection

Peace Corps Medical Clearance Survey

IC 179984 under ICR 200705-0420-005 · OMB 0420-0538.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Zoomerang MCS edited for PRA submission.doc	Other-Survey

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.