Information Collection

Peace Corps Response Reference Forms

IC 198820 under ICR 201410-0420-003 · OMB 0420-0548.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0420-0548 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form PC-2136 Peace Corps Response Reference Forms	Form and Instruction
PC-2136 Professional Reference Form Professional Reference Form_PCR_FINAL.docx	Form and Instruction
PC-2137 Personal Reference Form Personal Reference Form_PCR_FINAL.docx	Form and Instruction
PC-2138 Peace Corps Staff Reference Form PC Staff Reference Form_PCR_FINAL.docx	Form and Instruction

IC Title:

Peace Corps Response Reference Forms

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	PC-2136	Professional Reference Form	Professional Reference Form_PCR_FINAL.docx	Yes	Yes	Fillable Fileable
Form and Instruction	PC-2137	Personal Reference Form	Personal Reference Form_PCR_FINAL.docx	Yes	Yes	Fillable Fileable
Form and Instruction	PC-2138	Peace Corps Staff Reference Form	PC Staff Reference Form_PCR_FINAL.docx	Yes	Yes	Fillable Fileable

Line of Business: International Affairs and Commerce

Subfunction: International Development and Humanitarian Aid

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 700

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,575	875	700
Annual IC Time Burden (Hours)	263	146	117
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.