Peace Corps Fellows/USA Program Improvement Survey

Forms and Documents

Document Name	Status
Form PC-425-1 Peace Corps Fellows/USA Program Improvement Survey Form	Modified
0420-0537 Supporting Statement 2.docx Supporting Statement A	2011-11-08

IC Document Collections

IC ID	Document Title	Status
943	Peace Corps Fellows/USA Program Improvement Survey Form	Modified

ICR Details

OMB Control No: 0420-0537	ICR Reference No: 201104-0420-002
Status: Historical Inactive	Previous ICR Reference No: 200604-0420-001
Agency/Subagency: PEACE	Agency Tracking No:
Title: Peace Corps Fellows/USA Program Improvement Survey
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 12/01/2011
	Date Received in OIRA: 08/09/2011
Terms of Clearance: Agency requested to withdraw this collection as a result of budgetary issues. If the collection is re-instated, the agency shall disclose the burden of this survey on its website and monetize burden.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Form is intended to receive voluntary feedback from Peace Corps Volunteers who have previously contacted our office for Fellows/USA program information but have not enrolled to date. Responses will be used internally to improve the program

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Authorizing Statute(s): US Code: 22 USC 2501 Name of Law: Peace Corps Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 25379	05/04/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 41312	07/13/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Peace Corps Fellows/USA Program Improvement Survey	PC-425-1	Fellows/USA Program Improvement Survey

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Change in burden is attributable to the information collection being submitted as a reinstatement.

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Annual Cost to Federal Government: $500

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/09/2011

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