Peace Corps Volunteer Authorization for Examination and/or Treatment

Peace Corps Volunteer Authorization for Examination and/or Treatment

OMB: 1240-0059

IC ID: 236890

Information Collection (IC) Details

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Peace Corps Volunteer Authorization for Examination and/or Treatment
 
No New
 
Voluntary
 
20 CFR 10.731 20 CFR 10.730

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CA-15 Peace Corps Volunteer Authorization for Examination and/or Treatment Peace Corps Volunteer Authorization for Examination and or Treatment (CA-15).pdf No   Paper Only

Health Health Care Services

DOL/GOVT-1  81 FR 47418

252 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 252 252 0 0 0 0
Annual IC Time Burden (Hours) 63 63 0 0 0 0
Annual IC Cost Burden (Dollars) 146 146 0 0 0 0

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

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