Information Collection

Peace Corps Response Interview Assessment Form

IC 214707 under ICR 201709-0420-006 · OMB 0420-0556.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0420-0556 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form PC-2135 Peace Corps Response Interview Assessment Form	Form and Instruction
PC-2135 Peace Corps Response Interview Assessment Form Interview Assessment Form_PCR_Final.docx	Form and Instruction

IC Title:

Peace Corps Response Interview Assessment Form

Agency IC Tracking Number:

PC-2135

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-2135	Peace Corps Response Interview Assessment Form	Interview Assessment 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: 1,000

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,000	300	700
Annual IC Time Burden (Hours)	1,000	300	700
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.