Supporting Statement-PCR Interview Asessment-Final 11-2

Supporting Statement-PCR Interview Asessment-Final 11-2.docx

Peace Corps Response Interview Assessment Form

OMB: 0420-0556

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Peace Corps

Office of Peace Corps Response

OMB Control Number 0420-XXXX

Supporting Statement-Peace Corps Response Interview Assessment Form




General instructions


The supporting statement must be prepared in the format described below. If an item in applicable, use “N/A” and provide a brief explanation.


Section A: Justification


  1. Circumstances that make the collection of information necessary.


The Peace Corps Response interview is necessary to assess applicants’ qualifications and eligibility to serve in Peace Corps Response. The interview is a critical point in the recruitment process, as it is the point when the applicant and the recruitment and placement specialist verbally discuss the nature of the Volunteer assignment. Eligibility requirements for Peace Corps Volunteer service are set at 22 C.F.R. 305; attached.


  1. By whom, how, and for what purpose the information is to be used.

The information collected in the interview is used to determine whether an applicant would be a good candidate as a Peace Corps Response Volunteer. The information obtained from this form is used by the recruitment and placement specialists within the Office of Peace Corps Response.


There is no other means of obtaining the required data, and the information gathered is not shared with outside sources or other government agencies.


  1. Consideration of the use of improved information technology.

Peace Corps Response conducts interviews primarily over the phone, video chat, or in person. The Peace Corps Response recruitment and placement specialist takes notes during the interview, which are stored in an electronic database.


  1. Efforts to identify duplication. Why similar information cannot be used.

Peace Corps Response interviews are specific to the Volunteer assignment for which the candidate has applied. There is no other interview for the recruitment and placement specialist to use, so there is no duplication of efforts.


5. Methods to minimize the burden to small business if involved.


This collection of information does not impact small business or other small entities.



  1. Consequences to the Federal program if collection were conducted less frequently.

If Peace Corps Response were unable to conduct an interview, the program would be unable to adequately assess applicants’ eligibility, qualifications and suitability. Peace Corps Response Volunteers are representatives of the United States. An inadequately screened Peace Corps Response Volunteer may have poor performance, bad judgment or lacking qualifications. Such Volunteers may create conflict and embarrassment for the United States by attracting negative media or political attention.


7. Explain any special circumstances that would cause the information collection to be conducted in a manner inconsistent with guidelines.


No special circumstances exist that require the information collection to be conducted in a manner inconsistent with the guidelines in 5 CFR 1320.6.


8. Consultation.


The agency’s 60-day notice was published in the Federal Register on July 12, 2017 82 FR 32208. No public comments were received. The 30-Day notice was published September 18, 2017, 82 FR 43576 No public comments were received.


9. Explain any decision to provide any payment or gift to respondents.


No payments or gifts are provided to respondents.


10. Describe any assurance of confidentiality provided to respondents.


All applicants selected for an interview will receive an interview confirmation email from Peace Corps Response. The body of the email will include the following text:



In closing, I ask that you please review the Privacy Act statement (located below my signature) regarding the interview.

Privacy Act
The Peace Corps, an agency of the federal government, is required by the Privacy Act of 1974 (5 U.S.C. 552a) to advise you of the following information regarding this interview. The Privacy Act addresses the federal government’s use of certain personal information in agency files. The interview is part of the application process for Peace Corps Response service.

A. This application is authorized by the Peace Corps Act (22 U.S.C. 2501 et seq.) as amended.

B. The interview will be used is to evaluate your suitability and qualifications to serve as a Peace Corps Response Volunteer.

C. This information may be used for the routine uses described in the Privacy Act, 5 U.S.C. 552a, and the Peace Corps' published Routine Uses, summarized in
Peace Corps' System of Records.

D. The participation in and completion of this interview is voluntary. However, failure to participate in or to complete the interview will result in the Peace Corps being unable to assess your qualifications and may preclude your consideration for Peace Corps Response.


11. Additional justification for any questions of a sensitive nature.


No questions of a sensitive nature are asked.


12. Estimates of reporting and recordkeeping hour and cost burdens of the collection of information.


    1. Number of interviewed applicants: 1000

    2. Frequency of response: One time

    3. Completion time: 60 minutes

    4. Annual burden hours: 1000


13. Estimates of annualized capital and start-up costs.


Cost estimate to the respondent: $0.00


14. Estimates of annualized Federal Government costs.


Total annual cost to the Federal government per annum: $31,946


  1. Number interviews conducted: 1000

  2. Annual burden hours: 1000 (60 minutes per interview)

  3. Labor cost: $31,964

1000 hours/12480hours per year (2080 hours per year times 6 RPSs) = 8% of Recruitment and Placement Specialists’ time;

8% of Recruiters’ salary * $66,555 average Recruitment and Placement Specialist annual salary * 6 Recruitment and Placement Specialists

15. Explanation of change in burden.


No changes.


16. Information collections data planned to be published for statistical use.


The results of this collection of information will not be published.


17. Explanation for seeking not to display the expiration date for OMB approval of the information collection.


The Agency is not seeking approval to conceal or omit the expiration date for OMB approval of the information collection. The Privacy Act statement, Paperwork Reduction Act statement OMB control number, and expiration date will be listed in email sent to applicants prior to the interview during which the interview questions in this submission are used.


18. Exception to the certification statement.


The agency is able to certify compliance with all provisions under Item 19 of OMB Form 83-I.



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File TitlePeace Corps – Office of Volunteer Recruitment and Selection
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