Supporting Statement-Domestic Partners v2

Peace Corps

AFFIDAVIT DECLARING DOMESTIC PARTNER RELATIONSHIP

OMB Control Number (0420-xxxx)

Supporting Statement

Section A: Justification

Explain the circumstances that make the collection of information necessary. Identify any legal or administrative requirements that necessitate the collection. Attach a copy of the appropriate section of each statute and regulation mandating or authorizing the collection of information.

1. The Peace Corps has long placed heterosexual married couples together overseas as Volunteers, assigning them to the same site.  Placing a couple is more complicated and difficult than placing individuals, however, because it requires finding a single location where both members of the couple can have assignments consistent with their skills. Although Peace Corps Volunteers are not employees, 22 USC § 2504(a), Peace Corps would like to provide the same benefits to all domestic partners. Therefore, the Peace Corps will for the first time begin accepting applications from domestic partners who meet the following criteria for placement together as Volunteer couples.

Domestic partners may apply to be placed as a couple if the couple meets the following criteria:

• They are both applicants for Peace Corps service;

• They are each other's domestic partner and intend to remain committed to one another indefinitely;

• They have a common residence and intend to continue the arrangement; or would have a common residence, but are prevented from having one;

• They are at least 18 years of age and mentally competent to consent to contract;

• They share responsibility for a significant measure of each other's financial obligations;

• They are not married to, joined in civil union with, or domestic partners with anyone else; and

• They are not related in a way that would prohibit legal marriage in the state in which they reside.

For domestic partners applying to serve together the Peace Corps will ask each member of the domestic partnership to sign an affidavit attesting that their relationship meets the above criteria.

The referenced criteria are modeled after the criteria used for employees by Peace Corps for the purposes of obtaining benefits and assuming obligations under the Peace Corps Manual.

Indicate how, by whom, and for what purpose the information is to be used. Except for a new collection, indicate the actual use the agency has made of the information received from the current collection.

2. This form seeks information necessary for the Peace Corps’ Office of Volunteer Recruitment and Selection to verify that a domestic partner couple applying to be accepted and placed together as Peace Corps Volunteers meet accepted criteria for placement as a couple. The information is aimed at ensuring that the relationship is a committed one. The information will be collected from domestic partner applicants requesting placement as a couple.

Describe whether, and to what extent, the collection of information involves the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submission of responses, and the basis for the decision for adopting this means of collection. Also describe any consideration of using information technology to reduce burden.

3. The collection will offer applicants the opportunity to receive the form electronically by downloading the form from the Peace Corps website, at least initially. The Peace Corps will incorporate it into its primary recruitment and placement electronic filing system (“DOVE”) as quickly as feasible.

Describe efforts to identify duplication. Show specifically why any similar information already available cannot be used or modified for use for the purposes described in Item 2 above.

4. The Peace Corps has reviewed this affidavit in order to identify and avoid duplication. Because the need for this information results from a new policy to accept domestic partner applicants for couple placement, the Peace Corps has no existing system in place to collect this information. Nor does it collect this information from the same people for any other purpose.

If the collection of information impacts small businesses or other small entities (Item 5 of OMB Form 83-I), describe any methods used to minimize burden.

5. The collection of information does not impact small businesses or other small entities.

Describe the consequence to Federal program or policy activities if the collection is not conducted or is conducted less frequently, as well as any technical or legal obstacles to reducing burden.

6. The purpose of the form is to ask for a declaration indicating that two applicants are in a domestic partnership for which they would like placement together as a couple. Because not all states offer a state-recognized status to same-sex or heterosexual couples who are unmarried in a committed relationship, this form is necessary to verify that the two applicants are eligible to be placed together as a domestic partnership. In an analogous context, i.e., where two applicants are seeking to be placed together because they are married, the Peace Corps requires a copy of the appropriate legal documentation.

If the information is not collected, the Peace Corps will be unable to verify with any certainty whether two domestic partner applicants seeking couple placement are in fact part of a domestic partnership. Placing a couple as Peace Corps Volunteers is more complicated and difficult than placing individuals, because it requires finding a single location where both members of the couple can have assignments consistent with their skills. Therefore, Peace Corps seeks to ensure that the couple is actually in a domestic partnership.

The Peace Corps has tried to make the information collection as simple as possible.

Explain any special circumstances that would cause an information collection to be conducted in a manner: * requiring respondents to report information to the agency more often than quarterly; * requiring respondents to prepare a written response to a collection of information in fewer than 30 days after receipt of it; * requiring respondents to submit more than an original and two copies of any document; * requiring respondents to retain records, other than health, medical, government contract, grant-in-aid, or tax records, for more than three years; * in connection with a statistical survey, that is not designed to produce valid and reliable results that can be generalized to the universe of study; * requiring the use of a statistical data classification that has not been reviewed and approved by OMB; * that includes a pledge of confidentiality that is not supported by authority established in statute or regulation, that is not supported by disclosure and data security policies that are consistent with the pledge, or which unnecessarily impedes sharing of data with other agencies for compatible confidential use; or * requiring respondents to submit proprietary trade secrets, or other confidential information unless the agency can demonstrate that it has instituted procedures to protect the information's confidentiality to the extent permitted by law.

7. There are no special circumstances.

If applicable, provide a copy and identify the date and page number of publication in the Federal Register of the agency's notice, required by 5 CFR 1320.8(d), soliciting comments on the information collection prior to submission to OMB. Summarize public comments received in response to that notice and describe actions taken by the agency in response to these comments. Specifically address comments received on cost and hour burden. Describe efforts to consult with persons outside the agency to obtain their views on the availability of data, frequency of collection, the clarity of instructions and recordkeeping, disclosure, or reporting format (if any), and on the data elements to be recorded, disclosed, or reported. Consultation with representatives of those from whom information is to be obtained or those who must compile records should occur at least once every 3 years - even if the collection of information activity is the same as in prior periods. There may be circumstances that may preclude consultation in a specific situation. These circumstances should be explained.

8. The agency's 60 and 30 day notice was published in the Federal Register on June 19, 2013, (78 FR 36794) and August 28, 2013 (78 FR 53173) respectively. The Peace Corps received two comments in response to its 60 day Federal Register notice. Both comments were from the Peace Corps Watch concerning the use of the words same sex couple instead of just couple.

Comment 1: “We believe it is wrong to define this request for status couples as defined as same sex as there are many status' of couples; such as married couples(types), unmarried couples, celibate couples, separate living accommodation couples, business couple associations, safety and security couple associations, as well as benefit associated couples.

 The request should not define couples as same sex as this discounts the volumous types of other couples that have equal rights to service, safety and benefits.  In addition, workers and countries will be limited services, safety and benefits and foreign aid based on the wording of this submission and questionnaire. The request should be worded as 'couples' only and resubmitted for review.”

Comment 2: “Method: ‘This should read '......."given to all domestic partner relationship applicants"..... ' "Respondents Obligation to Reply: Required to obtain or retain benefits." statement should be required on the form for those who wish to apply.

The form should also contain the conditions of employment as a Peace Corps worker in country for those who claim domestic partnerships, like, for example, adopting children, having children while serving, pregnancy while serving and the affidavit for domestic partner relationship application should be included in the Peace Corps manual as well as any policy affects from the new affidavit, application, benefits and service worker type of relationships amongst each other. In addition, Peace Corps policy should include declaration of domestic partnership during training, the three month probation period after swearing in as well as in service and during 3rd year extensions. The declaration of domestic partnership should not be limited among US government employees, US citizens, Peace Corps workers or formal status requirements.

The request discounts the volumous types of other couples that have equal rights to service, safety and security and benefits. In addition, workers and countries will be limited services, safety and benefits and foreign aid based on the wording of this submission and questionnaire.

The request should be worded as we indicate and resubmitted for review.”

The original affidavit submitted to OMB for the review process indicated a “domestic partner means a person in a same sex relationship with the applicant for Peace Corps service” we are revising the originally submitted affidavit to capture a wider, more inclusive group of unmarried couples who wish to serve together as Peace Corps volunteers.  The revised affidavit eliminates the words “same sex”  in the definition of “domestic partner” and in the definition of “domestic partnership” and adds the word “committed” to the definition of domestic partner to more closely align with our definition of “domestic partnership” which uses the phrase “committed relationship.” Peace Corps will treat all married couples the same and all unmarried couples the same.  We will accept applications from any unmarried couple who is willing to sign the proposed revised affidavit and agree to the stated requirements. 

In terms of the additional comments on Peace Corps policy and training this will be dealt with in another medium. The sole purpose of this form is to ask for a declaration indicating that two applicants are in a domestic partnership for which they would like placement together as a couple.

Explain any decision to provide any payment or gift to respondents, other than reenumeration of contractors or grantees.

9. Respondents submit their information voluntarily. No payment or gifts will be made to respondents.

Describe any assurance of confidentiality provided to respondents and the basis for the assurance in statute, regulation, or agency policy.

10. Applicants who sign this form are provided no specific promise of confidentiality. However, the form will become a part of their Peace Corps applicant file, which is part of the Peace Corps’ Privacy Act System of Records (PC-17). Applicants are informed that their applicant files will be maintained in accordance with the Privacy Act (5 U.S.C. § 552a).

Provide additional justification for any questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private. This justification should include the reasons why the agency considers the questions necessary, the specific uses to be made of the information, the explanation to be given to persons from whom the information is requested, and any steps to be taken to obtain their consent.

11. The purpose of the form is to ask for a declaration indicating that two applicants are in a domestic partnership for which they would like placement together as a couple. In an analogous context, i.e., where two applicants are seeking to be placed together because they are married, the Peace Corps requires a copy of the appropriate legal documentation.

Provide estimates of the hour burden of the collection of information. The statement should: * Indicate the number of respondents, frequency of response, annual hour burden, and an explanation of how the burden was estimated. Unless directed to do so, agencies should not conduct special surveys to obtain information on which to base hour burden estimates. Consultation with a sample (fewer than 10) of potential respondents is desirable. If the hour burden on respondents is expected to vary widely because of differences in activity, size, or complexity, show the range of estimated hour burden, and explain the reasons for the variance. Generally, estimates should not include burden hours for customary and usual business practices. * If this request for approval covers more than one form, provide separate hour burden estimates for each form and aggregate the hour burdens in Item 13 of OMB Form 83-I. * Provide estimates of annualized cost to respondents for the hour burdens for collections of information, identifying and using appropriate wage rate categories. The cost of contracting out or paying outside parties for information collection activities should not be included here. Instead, this cost should be included in Item 13.

12. Number of Respondents: 325

This information was based on estimates from Peace Corps recruiting offices of the number of inquiries received in FY2011-2013.

Frequency of Response: 1

Completion Time: x 2 minutes

Total Annual Hour Burden: 10.833

Provide an estimate for the total annual cost burden to respondents or recordkeepers resulting from the collection of information. (Do not include the cost of any hour burden shown in Items 12 and 14). * The cost estimate should be split into two components: (a) a total capital and start-up cost component (annualized over its expected useful life) and (b) a total operation and maintenance and purchase of services component. The estimates should take into account costs associated with generating, maintaining, and disclosing or providing the information. Include descriptions of methods used to estimate major cost factors including system and technology acquisition, expected useful life of capital equipment, the discount rate(s), and the time period over which costs will be incurred. Capital and start-up costs include, among other items, preparations for collecting information such as purchasing computers and software; monitoring, sampling, drilling and testing equipment; and record storage facilities. * If cost estimates are expected to vary widely, agencies should present ranges of cost burdens and explain the reasons for the variance. The cost of purchasing or contracting out information collections services should be a part of this cost burden estimate. In developing cost burden estimates, agencies may consult with a sample of respondents (fewer than 10), utilize the 60-day pre-OMB submission public comment process and use 10/95 existing economic or regulatory impact analysis associated with the rulemaking containing the information collection, as appropriate. * Generally, estimates should not include purchases of equipment or services, or portions thereof, made: (1) prior to October 1, 1995, (2) to achieve regulatory compliance with requirements not associated with the information collection, (3) for reasons other than to provide information or keep records for the government, or (4) as part of customary and usual business or private practices.

13. Cost estimate to the respondent: $0.00

Provide estimates of annualized costs to the Federal government. Also, provide a description of the method used to estimate cost, which should include quantification of hours, operational expenses (such as equipment, overhead, printing, and support staff), and any other expense that would not have been incurred without this collection of information. Agencies may also aggregate cost estimates from Items 12, 13, and 14 in a single table.

14. Estimated cost to the Federal Government: Projected additional costs are $733.01. Costs consist of three components:

(A.) One-time costs of $537.24 to create affidavit (= 3 staff members x 4 hours each x avg. hourly salary of $44.77); plus

(B.) One-time cost of $13.89 to upload and validate affidavit template within on-line DOVE system (= 1 staff member x 0.25 hours x $55.56 hourly salary); plus

(C.) Annual costs of $181.88 to review (= 325 affidavits/yr. x 1 staff member per affidavit x $44.77 avg. hourly salary x 0.0125 hrs. per affidavit).

Explain the reasons for any program changes or adjustments reported in Items 13 or 14 of the OMB Form 83-I.

15. N/A.

For collections of information whose results will be published, outline plans for tabulation and publication. Address any complex analytical techniques that will be used. Provide the time schedule for the entire project, including beginning and ending dates of the collection of information, completion of report, publication dates, and other actions.

16. This information will not be quantified or published, except to the extent that statistics on the number of domestic partner couples serving as Volunteers may be included in Peace Corps reports.

If seeking approval to not display the expiration date for OMB approval of the information collection, explain the reasons that display would be inappropriate.

17. The Peace Corps will display the expiration date for OMB approval of the information collection.

Explain each exception to the certification statement identified in Item 19, "Certification for Paperwork Reduction Act Submissions," of OMB Form 83-I.

18. There are no exceptions to the certification statement identified in Item 19 of OMB Form 83-1.

Section B. Collection of Information Employing Statistical Methods

This collection of information does not employ statistical methods.