Health Status Review

Peace Corps Health History Form

OMB: 0420-0510

IC ID: 917

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Health Status Review
 
No Removed
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction PC-1789 Health Status Review HSR_FINAL_03042010_V2.pdf Yes No Paper Only

International Affairs and Commerce International Development and Humanitarian Aid

Volunteer Applicant and Service Records System (PC-17)  70 FR 1

9,700 0
   
Individuals or Households
 
   93 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 0 0 -9,700 0 0 9,700
Annual IC Time Burden (Hours) 0 0 -7,275 0 0 7,275
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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