Information Collection

Pecace Corps Volunteer Application

IC 905 under ICR 201610-0420-006 · OMB 0420-0005.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0420-0005 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
OMBNumberScreenShot_2014.5.9.jpg	Other-Screenshot of OMB Number
OMB 0420-0005 Peace Corps Volunteer Application PCV Application_OMB (Nov16).docx	Form and Instruction
Systems_of_Records_(revised_7-2-13)[1].docx System of Records (PC-17)	IC Document
PCV_Application_PIA.pdf Peace Corps Volunteer Application- PIA	IC Document
Volunteer Application Screen Shots.docx Screenshots	IC Document
Screenshot with edits marked.docx Screenshot showing edits needed	IC Document

IC Title:

Pecace Corps Volunteer Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 22 CFR 305

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
Other-Screenshot of OMB Number			OMBNumberScreenShot_2014.5.9.jpg		Yes	Yes	Fillable Fileable Signable
Form and Instruction	OMB 0420-0005	Peace Corps Volunteer Application	PCV Application_OMB (Nov16).docx		Yes	Yes	Fillable Fileable Signable

Line of Business: International Affairs and Commerce

Subfunction: International Development and Humanitarian Aid

Privacy Act System of Records

Title: Volunteer Applicant and Service Records System (PC-17)

FR Citation: 70 FR 1

Number of Respondents: 23,000

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	23,000	3,000	20,000
Annual IC Time Burden (Hours)	23,000	3,000	20,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
System of Records (PC-17)	Systems_of_Records_(revised_7-2-13)[1].docx	04/28/2014
Peace Corps Volunteer Application- PIA	PCV_Application_PIA.pdf	04/28/2014
Screenshots	Volunteer Application Screen Shots.docx	03/07/2017
Screenshot showing edits needed	Screenshot with edits marked.docx	03/07/2017

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.