Information Collection

Civilian Response Corps Database In-Processing Electronic Form

IC 15060 under ICR 201208-1405-006 · OMB 1405-0168.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS4096 Civilian Response Corps Database In-Processing Electronic Form Civilian Response Corps Database In-Processing Electronic Form	Form and Instruction
DS4096 Civilian Response Corps Database In-Processing Electroni CRC Electronic Application (20July12).pdf crc.state.gov	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DS4096			https://crc.state.gov	Yes	Yes	Fillable Fileable

Line of Business: International Affairs and Commerce

Subfunction: International Development and Humanitarian Aid

Privacy Act System of Records

Title: Office of the Coordinator for Reconstruction and Stabilization Records

FR Citation: 74 FR 28088

Number of Respondents: 2,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	2,000	2,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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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