Youth Conservation Corps Medical History

Youth Conservation Corps Medical History & Youth Conservation Corps (YCC) Application

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0596-0084 can be found here:

Documents and Forms

Document Name Document Type
Form FS-1800-3 Youth Conservation Corps Medical History Form and Instruction
FS-1800-3 YCC Medical History fs_1800_3_YCC_Medical_History[1].doc Form and Instruction
PA_USDA_FS_27.doc Privacy Act USDA/FS-27 YCC Enrollee Medical Records IC Document
PA_Interior_OS_27.doc PA Interior/OS-27 YCC Enrollee Medical Records IC Document

Information Collection (IC) Details

IC Title:	Youth Conservation Corps Medical History	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FS-1800-3	YCC Medical History	fs_1800_3_YCC_Medical_History[1].doc		Yes	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: USDA/FS-27	FR Citation: 40 FR 38945

Number of Respondents: 3,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,000	1,000	2,000
Annual IC Time Burden (Hours)	700	233	467
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Privacy Act USDA/FS-27 YCC Enrollee Medical Records	PA_USDA_FS_27.doc	12/04/2006
PA Interior/OS-27 YCC Enrollee Medical Records	PA_Interior_OS_27.doc	12/04/2006

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.