Information Collection

Civilian Response Corps Database In-Processing Form

IC 15060 under ICR 200906-1405-002 · OMB 1405-0168.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0168 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-4096 Civilian Response Corps Database In-Processing Form	Form and Instruction
DS-4096 Civilian Response Corps Database In-Processing Form ds4096 revised.pdf	Form and Instruction

IC Title:

Civilian Response Corps Database In-Processing Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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
Form and Instruction	DS-4096	Civilian Response Corps Database In-Processing Form	ds4096 revised.pdf		No		Paper Only

Line of Business: International Affairs and Commerce

Subfunction: International Development and Humanitarian Aid

Privacy Act System of Records

Title: ÂÂOffice of the Coordinator for Reconstruction and Stabilization Records

FR Citation: 74 FR 112

Number of Respondents: 2,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,000	-400	2,400
Annual IC Time Burden (Hours)	2,000	800	1,200
Annual IC Cost Burden (Dollars)	0	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.