Information Collection

Mail-in or Phone-In Donation Form

IC 226964 under ICR 202205-0420-002 · OMB 0420-0564.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0420-0564 can be found here:

Documents and Forms

Document Name Document Type
Form PC-2143B Mail-in or Phone-In Donation Form Form
PC-2143B Peace Corps Mail-in or Phone-In Donation form PC-2143B Mail or Phone-In Donation Form (2022).DOCX files.peacecorps.gov/multimedia/pdf/donors/Peace_Corps_Donation_Form.pdf Form
PC-2143B Peace Corps Mail-in or Phone-In Donation form PC-2143B Mail or Phone-In Donation Form (2022).DOCX files.peacecorps.gov/multimedia/pdf/donors/Peace_Corps_Donation_Form.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Mail-in or Phone-In Donation Form	Agency IC Tracking Number:	PC-2143B

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	PC-2143B	Peace Corps Mail-in or Phone-In Donation form	PC-2143B Mail or Phone-In Donation Form (2022).DOCX	https://files.peacecorps.gov/multimedia/pdf/donors/Peace_Corps_Donation_Form.pdf	No		Printable Only

Line of Business: International Affairs and Commerce

Subfunction: International Development and Humanitarian Aid

Privacy Act System of Records
Title: PC-10, Office of Private Sector Initiatives Database	FR Citation: 73 FR 59685

Number of Respondents: 180	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	180	-860	1,040
Annual IC Time Burden (Hours)	30	-143	173
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.