[Federal Register Volume 68, Number 250 (Wednesday, December 31, 2003)]
[Notices]
[Pages 75658-75659]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-32152]


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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 [email protected]">David_[email protected]. Comments on the 
form should also be addressed to the attention of Mr. Rostker, David 
[email protected] 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