Peace Corps National Agency Check (NAC) Questionnaire Form for Peace Corps Volunteer Background Investigations

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0005 Peace Corps National Agency Check (NAC) Questionnaire Form for Peace Corps Volunteer Background Investigations	Form and Instruction	Modified	Available
Emergency Request Letter to OMB 0420-0001.pdf	Supplementary Document	Uploaded 2011-05-23	Available
Emergency Clearance Supporting Statement.pdf	Supporting Statement A	Uploaded 2011-05-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
900	Peace Corps National Agency Check (NAC) Questionnaire Form for Peace Corps Volunteer Background Investigations	Form and Instruction	Modified

ICR Details

OMB Control No: 0420-0001	ICR Reference No: 201105-0420-001
Status: Historical Active	Previous ICR Reference No: 200711-0420-002
Agency/Subagency: PEACE	Agency Tracking No:
Title: Peace Corps National Agency Check (NAC) Questionnaire Form for Peace Corps Volunteer Background Investigations
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 06/08/2011
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/08/2011
	Date Received in OIRA: 05/23/2011
Terms of Clearance: OMB notes that this collection has been in use without a valid OMB control number.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2011	09/30/2011
Responses	13,500	0	0
Time Burden (Hours)	3,375	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Peace Corps Act requires a NAC background investigation of all Volunteers to ensure suitability consistent with the national interests established by the President for standards and procedures fulfilling the statutory requirements. The NAC background check form is used to screen Peace Corps applicants for legal and criminal history. The information obtained on the form is provided to the Office of Personnel Management to obtain the necessary information as to an applicant's suitability for service. All applicants who complete the initial Peace Corps Application Form are sent a "legal kit" to complete, which includes this form among others related to the applicants' suitability.

Emergency Justfication: This request meets the criteria of 5 CFR 1320.13 in that the collection of information is needed prior to the expiration of time periods established under 5 CFR 1320, it is essential to the mission of Peace Corps to collect this information. The Office of Volunteer Recruitment and Selection at the Peace Corps utilizes the NAC form as authorization from the candidate to conduct a formal background check through the Office of Personnel Management, which has access to pertinent records pertaining to applicants’ legal activities and suitability for Peace Corps volunteer service. The Peace Corps Act requires the Director of the Peace Corps to ensure that the assignment of volunteers is consistent with the national interest in accordance with the standards and procedures established by the President of the United States. 22 U.S.C. 2519. We are seeking an emergency clearance to allow us to continue our eligibility and selection process. 22 CFR §§ 305.3 and 305.4.

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Authorizing Statute(s): US Code: 22 USC 2519 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

Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Peace Corps National Agency Check (NAC) Questionnaire Form for Peace Corps Volunteer Background Investigations	0005	National Agency Check Questionnaire for Peace Corps Volunteer Background Investigation

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	13,500	0	0	0	1,500	12,000
Annual Time Burden (Hours)	3,375	0	0	0	-8,625	12,000
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: Change in burden due to PRA Violation. The form expired 02/2011 and is currently in use without OMB's approval.

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Annual Cost to Federal Government: $48,073

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: 05/23/2011

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