Peace Corps Confidential Reference Form

ICR 201705-0420-001

OMB: 0420-0006

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
New
Justification for No Material/Nonsubstantive Change
2015-10-20
Justification for No Material/Nonsubstantive Change
2014-07-30
Supporting Statement A
2017-08-30
Supplementary Document
2011-02-04
IC Document Collections
ICR Details
0420-0006 201705-0420-001
Historical Active 201510-0420-003
PEACE PC-1532
Peace Corps Confidential Reference Form
Revision of a currently approved collection   No
Regular
Approved with change 08/31/2017
Retrieve Notice of Action (NOA) 05/16/2017
  Inventory as of this Action Requested Previously Approved
08/31/2020 36 Months From Approved 03/31/2018
18,000 0 40,000
3,000 0 6,667
0 0 0

The reference form is a tool that the Peace Corps employs to ensure a standardized suitability review of applicants. The Assessment and Placement Officer requests the completion of the reference form and uses the information therein to assist in determining the suitability and competitiveness of the applicant. The reference form is an integral part of the selection process to determine whether an applicant is likely to succeed as a Peace Corps volunteer.

US Code: 22 USC 2504 Name of Law: Peace Corps Act
  
US Code: 22 USC 2501 et seq Name of Law: Peace Corps Act

Not associated with rulemaking

  82 FR 12143 02/28/2017
82 FR 23356 05/15/2017
No

1
IC Title Form No. Form Name
Peace Corps Confidential Reference Form PC-1532 Peace Corps Confidential Reference Form

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 18,000 40,000 0 -22,000 0 0
Annual Time Burden (Hours) 3,000 6,667 0 -3,667 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Using Information Technology
The reference form employs the use of information technology to make the collection of the data electronic, reducing time for references and the use of agency resources. The use of a standardized, automated electronic form improves the quality of the information collected by ensuring that the same information is received from all references. It also ensures the confidentiality of the content, as the reference submits the form directly to the Peace Corps, and not through the applicant.

$15,000
No
    Yes
    Yes
No
No
No
Uncollected
Denora Miller 202 692-1236 dmiller4@peacecorps.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
05/16/2017


© 2024 OMB.report | Privacy Policy