OMB 0420-0533 Supporting Statement

Peace Corps
Peace Corps Response Application Form
OMB Approval No. 0420-0533
Supporting Statement
Section A. Justification
1. The Peace Corps Response Application (hereinafter "the Application"), is necessary
to recruit qualified Volunteers to serve in Peace Corps Response., which deploys
volunteers throughout the world to work in short term assistance (6 months on
average) projects Applicants are recruited exclusively from the Returned Peace
Corps Volunteer community and are selected based on their qualifications for a
specific volunteer assignment. The Peace Corps Act (22 U.S.C. § 2501 et seq.)
authorizes the recruitment of persons for service in Peace Corps Volunteer programs.
See 22 U.S.C. § 2504. Eligibility requirements for Peace Corps Volunteer service are
set at 22 C.F.R. 305. Attached are 22 U.S.C. § 2504 and 22 C.F.R. 305.
2. This information is used by Peace Corps Response staff to perform initial screening
for potential candidates for specific Peace Corps Response assignments. The Peace
Corps Response Application is completed by applicants for Peace Corps Response
assignments to provide basic information concerning technical and language skills,
and availability for Peace Corps Response assignments.
3. The Peace Corps Response application is available on the Peace Corps website and
submitted electronically to Peace Corps Response.
4. The information requested in the Application does not exist in its entirety within the
Agency's records. Agency records concerning Volunteers' service experiences are
kept for a limited period. Even when records are available, Volunteers routinely
acquire new skills and languages during service that may not be reflected in Agency
records. Former Volunteers may have acquired new skills, degrees, or work
experience following their Peace Corps service.
5. This collection of information does not impact small business or other small entities.
Failure to collect this information would hinder Peace Corps Response's ability to
identify and place qualified and available Returned Peace Corps Volunteers and
Volunteers who are completing their Peace Corps service
6. No special circumstances exist that require the information collection to be conducted
in a manner inconsistent with the guidelines in 5 CFR 1320.6.
7. The agency’s notice was published in the Federal Register on August 20, 2010, 75 FR
51503 (August 20, 2010). No public comments were received during the 60-day
period.
8. No payments or gifts are provided to respondents.

9. Assurance of privacy provided to respondents is on the Privacy Act notice on the
bottom of the form.
11. No questions of a sensitive nature are asked.
12. Estimates of hour burden of the collection of information:
a) Estimated number of respondents
b) Frequency of response
c) Estimated average burden per response

d) Estimated total reporting burden

507
one time
5 minutes
42 hours

13. Cost estimate to the respondent: $0.00
14. Estimated cost to the Federal Government:
Employee labor costs:
Peace Corps Response Recruiter (reviewing):
($32 per hour x 522 hours (25% of time) x 6 recruiters)
Peace Corps Response Staff Assistant (processing):
($20 per hour x 209 hours (10% of time) x 1 assistant)
Total cost:
15.

$100224.00

$

4180.00

$104404.00

The number of applications that Peace Corps Response receives varies from year
to year and is dependent on a number of factors:
a)
Large scale disasters in countries where Peace Corps has current programs
or has had large programs in the past spawn a large number of applications.
b)
Resources available to the Peace Corps Response to carry out recruitment
activities such as attending conferences and workshops around the country,
strategic outreach campaigns and hosting and attending events designed to attract
Peace Corps Response Volunteers.
c)
Since our applicant pool is exclusively with the returned Peace Corps
Volunteer community, the number of applications varies according to the number
of Peace Corps Volunteers closing their service and their level of interest in
programs like the Peace Corps Response.

16. Not applicable. The results of this collection of information will not be published.
17. Not applicable. The Agency is not seeking approval to conceal or omit the expiration
date for OMB approval of the information collection.

18. The agency is able to certify compliance with all provisions under Item 19 of OMB
Form 83-I.
Section B. Collections of Information Employing Statistical Methods
The collection of information does not employ statistical methods.