[Federal Register: December 31, 2003 (Volume 68, Number 250)]
[Notices]
[Page 75658-75659]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr31de03-155]
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PEACE CORPS
Proposed Information Collection Requests
AGENCY: Peace Corps.
ACTION: Notice of public use form review request submission to the
Offices of Management and Budget (OMB Control Number 0420-0510).
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SUMMARY: Pursuant to the Paperwork Reduction Act of 1981 (44 U.S.C.
chapter 35), the Peace Corps has submitted to the Office of Management
and Budget (OMB) a request for approval of an information collection,
OMB Control Number 0420-0510, the Peace Corps Health Status Review form
(PC-1789) and the Report of Medical and Dental Exam forms (PC-1790 S
and PC-1790 Dental). This is a renewal of an active information
collection and a revision. The current active renewal covers the Peace
Corps Health Status Review form (PC-1789) and the Report of Medical
Exam (PC-1790 S). The revision is to add an HIV Aids question to the
PC-1789 form and to add the Report of Dental Exam form (PC-1790) to
this collection for a total of three forms to make up the health
applications for Peace Corps Volunteers. The purpose of this
information collection is necessary to ensure that Volunteers meet this
medical eligibility requirement, all applicants for service must
undergo physical and dental examination prior to Volunteer service 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 claims. The Health Status
Review is used to review the medical history of individual applicants;
the Report of Medical Exam and the Report of Dental Exam are used
[[Page 75659]]
by the examining physician and dentist both for applicants and for
currently serving Volunteers. The results of these examinations are
used to ensure that applicants for Volunteer service will, with
reasonable accommodation, be able to serve in the Peace Corps without
jeopardizing their health.
The purpose of this notice is to allow for public comment on
whether the proposed collection of information is necessary for the
proper performance of the functions of the Peace Corps, including
whether their information will have practical use; the accuracy of the
agency's estimate of the burden of the proposed collection of
information, including the validity of the methodology and assumptions
used; ways to enhance the quality, utility and the clarity of the
information to be collected; and, ways to minimize the burden of the
collection of information on those who are to respond, including
through the use of automated collection techniques, when appropriate,
and other forms of information technology.
A copy of the information collection may be obtained from the
Office of Management and Budget, Desk Officer for the Peace Corps, Mr.
David Rostker by e-mail at David_Rostker@omb.eop.gov. Comments on the
form should also be addressed to the attention of Mr. Rostker, David
Rostker@omb.eop.gov and should be received on or before January 30,
2004.
Information Collection Abstract
Title: The Peace Corps Health Status review form (PC-1789) and the
Report of Medical and Dental Exam forms (PC-1790 S and PC-1790 Dental).
Need for and use of this information: The Health Status Review is
used to review the medical history of individual applicants; the Report
of Medical Exam and the Report of Dental Exam are used by the examining
physician and dentist both for applicants and for currently serving
Volunteers. The results of these examinations are used to ensure that
applicants for Volunteer service will, with reasonable accommodation,
be able to serve in the Peace Corps without jeopardizing their health.
Respondents: Potential and current Volunteers.
Respondents's Obligation To Reply: Voluntary.
Burden on the Public:
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PC-1789 Health status PC-1790 S report of PC-1790 dental report of
review medical exam dental exam
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a. Estimated number of respondents.. 9,700.................. 6,000................. 6,000.
b. Estimated average burden per 45 minutes............. 30 minutes............ 30 minutes.
response.
c. Frequency of response............ one time............... one time.............. one time.
d. Annual reporting burden.......... 7,275 hours............ 3,000 hours........... 3,000 hours.
e. Estimated annual cost to $138,298............... $57,030............... $57,030.
respondents.
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This notice is issued in Washington, DC on December 23, 2003.
Ed Anderson,
Chief Information Officer.
[FR Doc. 03-32152 Filed 12-30-03; 8:45 am]
BILLING CODE 6051-01-M