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OMB Control No: 0420-0564	ICR Reference No: 202508-0420-001
Status: Received in OIRA	Previous ICR Reference No: 202205-0420-002
Agency/Subagency: PEACE	Agency Tracking No: PC-2143
Title: Office of Gifts and Grants Management Donation Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 08/08/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2025
Responses	13,050	900
Time Burden (Hours)	2,175	150
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	13,050	900	12,150
Annual Time Burden (Hours)	2,175	150	2,025
Annual Cost Burden (Dollars)	0	0	0

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The Agency continues to move to a 100% Online Donation Form and phase out the phone donation method. However, we still have donors who prefer to speak to a person or cannot use the Internet to donate.

Annual Cost to Federal Government: $17,925

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? No

Agency Contact: Jay Olin 202 692-2507 jolin@peacecorps.gov