96-22620. Proposed Information Collection Requests

[Federal Register Volume 61, Number 174 (Friday, September 6, 1996)]
[Notices]
[Pages 47215-47216]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-22620]


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PEACE CORPS


Proposed Information Collection Requests

AGENCY: Peace Corps.

ACTION: Notice of public use form review request to the Office of 
Management and Budget.

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SUMMARY: The Associate Director for Management invites comments on 
information collection requests as required pursuant to the Paperwork 
Reduction Act (44 U.S.C. chapter 35). This notice announces that the 
Peace Corps invites the general public and other federal agencies to 
take this opportunity to comment on the continued information 
collection below. A copy of the information collection may be obtained 
from Susan Gambino, Office of Medical Services, United States Peace 
Corps, 1990 K Street, NW, Washington, DC 20526. Ms. Gambino may be 
contacted by telephone at [phone]. Comments on these forms 
should be addressed to Victoria Becker Wassmer, Desk Officer, Office of 
Management and Budget, NEOB, Washington, DC 20503.

Information Collection Abstract

    Title: Medical History and Examination Forms.
    Need For and Use of This Information: This collection of 
information is necessary to comply with the Peace Corps Act (Section 
5(e)) which states that ``applicants for enrollment shall receive such 
health examinations preparatory to their service * * * as the President 
may deem necessary or appropriate * * * to provide the information 
needed for clearance, and to serve as a reference for any future 
Volunteer medical clearance, and to serve as a reference for any future 
Volunteer disability claim.'' Peace Corps uses this information to 
determine the physical and mental suitability for service as a Peace 
Corps Volunteer.
    Respondents: Peace Corps Applicants.
    Respondents Obligation to Reply: Mandatory.
    Burden on the Public:

Medical History Form (PC 1789)
    a. Annual reporting burden: 1,625 hrs.

[[Page 47216]]

    b. Annual recordkeeping burden: 0 hrs.
    c. Estimated average burden per response: 15 minutes.
    d. Frequency of response: One time.
    e. Estimated number of likely respondents: 6,500.
    f. Estimated cost to respondents: $3.04 per.

Medical History Form (PC 1789)
    a. Annual reporting burden: 3,000 hrs.
    b. Annual recordkeeping burden: 0 hrs.
    c. Estimated average burden per response: 30 minutes.
    d. Frequency of response: One time.
    e. Estimated number of likely respondents: 6,000.
    f. Estimated cost to respondents: $6.08 per.

     Responses will be returned by postage-paid reply mail.

    This notice is issued in Washington, DC on August 30, 1996.
Ron Conner,
Acting Associate Director for Management.
[FR Doc. 96-22620 Filed 9-5-96; 8:45 am]
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