Peace Corps Conversion Loss Survey

Forms and Documents

Document Name	Status
Email Invite Text.pdf Supplementary Document	2011-05-02
22 USC 2501.pdf Supplementary Document	2011-01-15
30-Day FR Notice.pdf Supplementary Document	2011-01-14
Survey 60 Day NOTICE.docx.pdf Supplementary Document	2011-01-14
Supporting Statement B VRS Survey.pdf Supporting Statement B	2011-04-28
Supporting Statement A VRS Survey.pdf Supporting Statement A	2011-04-28

IC Document Collections

IC ID	Document Title	Status
195944	Peace Corps Conversion Survey Other-Survey	New

ICR Details

OMB Control No: 0420-0544	ICR Reference No: 201101-0420-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: PEACE	Agency Tracking No:
Title: Peace Corps Conversion Loss Survey
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/11/2011
	Date Received in OIRA: 01/15/2011
Terms of Clearance: Yhis is approved given 18 month approval as it is a one-time collection by Peace Corps.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2012	36 Months From Approved
Responses	1,200	0	0
Time Burden (Hours)	400	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this survey is to collect feedback from Peace Corps applicants and returned Peace Corps volunteers to help understand factors that are driving recruitment attrition, as well as, what information or education would increase the conversion radio. An online survey will be conducted among 1,200 Peace Corps applicants and returned Peace Corps volunteers.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 68630	11/03/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 2727	01/14/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Peace Corps Conversion Survey

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ICR Summary of Burden

	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	1,200	0	0	1,200	0	0
Annual Time Burden (Hours)	400	0	0	400	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Modified annual time burden. Change reflects the average time it will take respondents to complete the survey.

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Annual Cost to Federal Government: $55,655

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 01/14/2011

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