OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Peace Corps Volunteer Authorization for Examination and/or Treatment

IC 236890 under ICR 202505-1240-004 · OMB 1240-0059.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form CA-15
Peace Corps Volunteer Authorization for Examination and/or Treatment		 Form and Instruction
Form CA-15
Peace Corps Volunteer Authorization for Examination And/Or Treatment Peace Corps Volunteer Authorization for Examination and/or Treatment		 Form and Instruction
CA-15 Peace Corps Volunteer Authorization for Examination And/
CA-15 Form OMB approved.pdf
www.ecomp.dol.gov/ 		Form and Instruction
CA-15 Peace Corps Volunteer Authorization for Examination And/
CA-15 Form OMB approved.pdf
www.ecomp.dol.gov/ 		Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 CA-15 https://www.ecomp.dol.gov/ Yes Yes Paper Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 48 0 -204 0 0 252
Annual IC Time Burden (Hours) 12 0 -51 0 0 63
Annual IC Cost Burden (Dollars) 10 0 -149 0 0 159

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.
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