View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0420-0546	ICR Reference No: 202011-0420-007
Status: Historical Inactive	Previous ICR Reference No: 201610-0420-004
Agency/Subagency: PEACE	Agency Tracking No: PC-1790
Title: Report of Dental Examinitaion
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: Yes
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted and continue	Conclusion Date: 10/20/2022
	Date Received in OIRA: 11/17/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2020	36 Months From Approved
Responses	5,600	0	0
Time Burden (Hours)	12,600	0	0
Cost Burden (Dollars)	1,008,000	0	0

Annual Cost to Federal Government: $87,733

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]? Yes

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

Is this ICR related to the Pandemic Response? No

Agency Contact: Virginia Burke 202 692-1887 vburke@peacecorps.gov

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