View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0420-0001	ICR Reference No: 201707-0420-001
Status: Historical Active	Previous ICR Reference No: 201509-0420-001
Agency/Subagency: PEACE	Agency Tracking No: PC-0005
Title: Peace Corps Questionnaire for Peace Corps Volunteer Background Investigations Form
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/19/2017
	Date Received in OIRA: 09/12/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2020	36 Months From Approved
Responses	5,000	0	0
Time Burden (Hours)	167	0	0
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses	5,000	500	4,500
Annual Time Burden (Hours)	167	-208	375
Annual Cost Burden (Dollars)	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to: Using Information Technology

Short Statement: a. The agency no longer incurs printing or mailing costs associated with the form. b. The agency has reduced the burden on Federal Employees by eliminating the number of staff that reviews the form. c. The agency maintains an electronic system through which the form collects the information.

Annual Cost to Federal Government: $1,200

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? Uncollected

Agency Contact: Denora Miller 202 692-1236 dmiller4@peacecorps.gov

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