Legal Status Update Form for the Virtual Service Pilot Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form PC-2196 Virtual Service Pilot Program	Form	New	Available
Emergency Clearance Letter to OMB PC-2196.docx	Supporting Statement B	Uploaded 2020-11-19	Available
Supporting Statement PC-2196 Legal Status Update Virtual Volunteer Pilot.docx	Supporting Statement A	Uploaded 2020-11-19	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
244528	Legal Status Update Form for the Virtual Service Pilot Program	Form	New	Virtual Service Pilot Program

ICR Details

OMB Control No: 0420-0574	ICR Reference No: 202011-0420-012
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: PEACE	Agency Tracking No: PC-2196
Title: Legal Status Update Form for the Virtual Service Pilot Program
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  Yes
Type of Review Request: Emergency	Approval Requested By: 11/20/2020
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/08/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/19/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2021	6 Months From Approved
Responses	150	0	0
Time Burden (Hours)	13	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Peace Corps plans to follow this emergency request with a submission for a three year approval through OMB’s normal PRA clearance process. We are seeking an emergency clearance to allow us to collect information from Returned Peace Corps Volunteers.

Emergency Justfication: Returned Peace Corps Volunteers, some who were recently evacuated from their countries of service in response to the coronavirus disease 2019 (COVID 19) pandemic. Respondents’ obligation to reply

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Legal Status Update Form for the Virtual Service Pilot Program	PC-2196	Virtual Service Pilot Program

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	150	0	0	150	0	0
Annual Time Burden (Hours)	13	0	0	13	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: New Form

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Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Yes

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Common Form ICR:  Yes

Description/Changes for Common Form Usage: 

Approved RCFs using this ICR

table that charts list of RCF

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/19/2020

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