Information Collection

Peace Corps Questionnaire for Peace Corps Volunteer Background Investigation Form

IC 900 under ICR 201401-0420-002 · OMB 0420-0001.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0420-0001 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form PC-0005 Peace Corps Questionnaire for Peace Corps Volunteer Background Investigation Form	Form and Instruction
PC-0005 Questionnaire for Peace Corps Volunteer Background Inves PC-0005 PCV Background check Questionnaire Form- Final.docx	Form and Instruction

IC Title:

Peace Corps Questionnaire for Peace Corps Volunteer Background Investigation Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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	PC-0005	Questionnaire for Peace Corps Volunteer Background Investigation	PC-0005 PCV Background check Questionnaire Form- Final.docx		No		Paper Only

Line of Business: International Affairs and Commerce

Subfunction: International Development and Humanitarian Aid

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	4,500	-9,000	13,500
Annual IC Time Burden (Hours)	150	-3,225	3,375
Annual IC Cost Burden (Dollars)	0	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.