Youth Conservation Corps Medical History

Youth Conservation Corps Medical History & Youth Conservation Corps (YCC) Application

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0596-0084 can be found here:

Documents and Forms

Document Name Document Type
Form FS-1800-3 Youth Conservation Corps Medical History Form and Instruction
FS-1800-3 YCC Medical History fs_1800_3_YCC_Medical_History.doc Form and Instruction
PA_USDA_FS_27.doc Privacy Act USDA/FS-27 YCC Enrollee Medical Records IC Document
PA_Interior_OS_27.doc PA Interior/OS-27 YCC Enrollee Medical Records IC Document

Information Collection (IC) Details

IC Title:	Youth Conservation Corps Medical History	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FS-1800-3	YCC Medical History	fs_1800_3_YCC_Medical_History.doc		Yes	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: USDA/FS-27	FR Citation: 40 FR 38945

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	467	467
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Privacy Act USDA/FS-27 YCC Enrollee Medical Records	PA_USDA_FS_27.doc	12/04/2006
PA Interior/OS-27 YCC Enrollee Medical Records	PA_Interior_OS_27.doc	12/04/2006

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.