Information Collection Request; Submission for OMB Review, 72124-72125 [2013-28732]
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72124
Federal Register / Vol. 78, No. 231 / Monday, December 2, 2013 / Notices
Dated: November 27, 2013.
Connie M. Downs,
OPIC Corporate Secretary.
[FR Doc. 2013–28901 Filed 11–27–13; 4:15 pm]
BILLING CODE 3210–01–P
PEACE CORPS
Information Collection Request;
Submission for OMB Review
Peace Corps.
60-day notice and request for
comments.
AGENCY:
ACTION:
The Peace Corps will be
submitting the following information
collection request to the Office of
Management and Budget (OMB) for
review and approval. The purpose of
this notice is to allow 60 days for public
comment in the Federal Register
preceding submission to OMB. We are
conducting this process in accordance
with the Paperwork Reduction Act of
1995 (44 U.S.C. Chapter 35).
DATES: Comments must be submitted on
or before January 31, 2014.
ADDRESSES: Comments should be
addressed to Denora Miller, FOIA/
Privacy Act Officer. Denora Miller can
be contacted by telephone at 202–692–
1236 or email at pcfr@peacecorps.gov.
Email comments must be made in text
and not in attachments.
FOR FURTHER INFORMATION CONTACT:
Denora Miller at Peace Corps address
above.
SUMMARY:
emcdonald on DSK67QTVN1PROD with NOTICES
SUPPLEMENTARY INFORMATION:
Method: Applicants gain access to the
form via a secure online portal.
Applicants have to download the form
for their health care provider to
complete. The completed form can be
scanned and uploaded back into the
Applicant’s secure Peace Corps online
portal or they can be faxed or mailed to
the Peace Corps Office of Medical
Services.
Title: Peace Corps Report of Physical
Examination (PC 1790S)
OMB Control Number: 0420–0549
Type of Request: Extension without
change of a currently approved
collection.
Affected Public: Individuals/
Physicians.
Respondents Obligation to Reply:
Voluntary.
Burden to the Public:
a. Estimated number of respondents/
physicians: 4,000/4,000.
b. Estimated average burden per
response: 90 minutes/45 minutes.
c. Frequency of response: one time.
d. Annual reporting burden: 6,000
hours/3,000 hours.
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20:41 Nov 29, 2013
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e. Estimated annual cost to respondents:
Indeterminate
General Description of Collection: The
Peace Corps Act requires that
Volunteers receive health examinations
prior to their service. The information
collected is required for consideration
for Peace Corps Volunteer service. After
completion of the Health History Form
and after passing preliminary nonhealth-related assessments, the
Applicant will be ‘‘nominated’’ to a
program. This nomination does not
guarantee an invitation to serve, but it
does hold a place so the Applicant may
proceed with the process. After a review
by the Peace Corps pre-service medical
staff of the Health History Form and any
supplemental forms that the Applicant
is required to submit following
nomination (covered under OMB
control number 0420–0510), the
Applicant may be medically precleared. An Applicant who is medically
pre-cleared and who accepts an
invitation to serve as a Peace Corps
Volunteer undergoes a final medical
clearance. Final medical clearance is on
the basis of a complete physical
examination, as documented in a Report
of Physical Examination (PC–1790S).
The information contained in the
Report of Physical Examination will be
used to make an individualized
determination as to whether an
Applicant for Volunteer service will,
with reasonable accommodation, be able
to perform the essential functions of a
Peace Corps Volunteer and complete a
tour of service without undue
disruption due to health problems and,
if so, to establish the level of medical
and other support, if any, that may be
required to reasonably accommodate the
Applicant.
Request For Comment: Peace Corps
invites comments on whether the
proposed collections of information are
necessary for proper performance of the
functions of the Peace Corps, including
whether the 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 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.
This notice is issued in Washington, DC,
on November 21, 2013.
Denora Miller,
FOIA/Privacy Act Officer, Management.
[FR Doc. 2013–28731 Filed 11–29–13; 8:45 am]
BILLING CODE 6051–01–P
PO 00000
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PEACE CORPS
Information Collection Request;
Submission for OMB Review
Peace Corps.
60-day notice and request for
comments.
AGENCY:
ACTION:
The Peace Corps will be
submitting the following information
collection request to the Office of
Management and Budget (OMB) for
review and approval. The purpose of
this notice is to allow 60 days for public
comment in the Federal Register
preceding submission to OMB. We are
conducting this process in accordance
with the Paperwork Reduction Act of
1995 (44 U.S.C. Chapter 35).
DATES: Comments must be submitted on
or before January 31, 2014.
ADDRESSES: Comments should be
addressed to Denora Miller, FOIA/
Privacy Act Officer. Denora Miller can
be contacted by telephone at 202–692–
1236 or email at pcfr@peacecorps.gov.
Email comments must be made in text
and not in attachments.
FOR FURTHER INFORMATION CONTACT:
Denora Miller at Peace Corps address
above.
SUMMARY:
SUPPLEMENTARY INFORMATION:
Method: The Health History Form will
be completed online in an interactive
process in which only questions
relevant to each Applicant’s medical
history (based on responses to previous
questions) are presented.
Title: Peace Corps Volunteer Health
History Form (PC 1789).
OMB Control Number: 0420–0510.
Type of Request: Extension without
change of a currently approved
collection.
Affected Public: Individuals.
Respondents Obligation to Reply:
Voluntary.
Burden to the Public:
a. Estimated number of respondents:
10,000.
b. Estimated average burden per
response: 45 minutes.
c. Frequency of response: one time.
d. Annual reporting burden: 7,500
hours.
e. Estimated annual cost to respondents:
Indeterminate.
General Description of Collection: The
Peace Corps Act requires that
Volunteers receive health examinations
prior to their service. The information
collected is required for consideration
for Peace Corps Volunteer service. The
Health History Form is used to
document the medical history of each
individual Applicant. It is a self-report
of pre-existing medical conditions and
E:\FR\FM\02DEN1.SGM
02DEN1
Federal Register / Vol. 78, No. 231 / Monday, December 2, 2013 / Notices
is used to help determine whether the
Applicant will, with reasonable
accommodation, be able to perform the
essential functions of a Peace Corps
Volunteer and complete a tour of service
without undue disruption due to health
problems.
Request For Comment: Peace Corps
invites comments on whether the
proposed collections of information are
necessary for proper performance of the
functions of the Peace Corps, including
whether the 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 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.
This notice is issued in Washington, DC on
November 21, 2013.
Denora Miller,
FOIA/Privacy Act Officer, Management.
[FR Doc. 2013–28732 Filed 11–29–13; 8:45 am]
BILLING CODE 6051–01–P
PEACE CORPS
Information Collection Request;
Submission for OMB Review
Peace Corps.
60-Day notice and request for
comments.
AGENCY:
ACTION:
The Peace Corps will be
submitting the following information
collection request to the Office of
Management and Budget (OMB) for
review and approval. The purpose of
this notice is to allow 60 days for public
comment in the Federal Register
preceding submission to OMB. We are
conducting this process in accordance
with the Paperwork Reduction Act of
1995 (44 U.S.C. Chapter 35).
DATES: Comments must be submitted on
or before January 31, 2014.
ADDRESSES: Comments should be
addressed to Denora Miller, FOIA/
Privacy Act Officer, Peace Corps, 1111
20th Street NW., Washington, DC 20526.
Denora Miller can be contacted by
telephone at 202–692–1236 or email at
pcfr@peacecorps.gov. Email comments
must be made in text and not in
attachments.
FOR FURTHER INFORMATION CONTACT:
Denora Miller at Peace Corps address
above.
SUPPLEMENTARY INFORMATION:
Volunteers serve in developing
emcdonald on DSK67QTVN1PROD with NOTICES
SUMMARY:
VerDate Mar<15>2010
20:41 Nov 29, 2013
Jkt 232001
countries where western-style
healthcare is often not available.
Volunteers are placed in remote
locations where they may suffer
hardship because they have no access to
running water and/or electricity. They
also may be placed in locations with
extreme environmental conditions
related to cold, heat or high altitude and
they may be exposed to diseases not
generally found in the U.S. Volunteers
may be placed many hours from the
Peace Corps medical office and not have
easy access to any health care provider.
Therefore, a thorough review of an
Applicant’s past medical history is an
essential first step to determine their
suitability for service in Peace Corps.
The forms listed below may be sent to
an individual Applicant at one of the
following times in the medical review
process: (1) After the Applicant
completes the Health History Form and
receives a nomination; (2) after a Peace
Corps nurse reviews the Applicant’s
Health History Form and any completed
forms previously requested; or (3) at the
time of the Applicant’s physical
examination. The information contained
in the specific medical evaluation forms
will be used to make an individualized
determination as to whether an
Applicant for Volunteer service will,
with reasonable accommodation, be able
to meet the essential eligibility
requirements for a Peace Corps
Volunteer and complete a tour of service
without undue disruption due to health
problems.
Method: Applicants gain access to the
forms via a secure online portal.
Applicants will have to download the
forms for their health care providers to
complete. Completed forms can be
scanned and uploaded back into the
Applicant’s secure Peace Corps online
portal or they can be faxed or mailed to
the Peace Corps Office of Medical
Services.
Title: Individual Specific Medical
Evaluation Forms (16).
OMB Control Number: 0420–0550.
Type of Request: Extension without
change of a currently approved
collection.
Affected Public: Individuals/
Physicians.
Respondents’ Obligation to Reply:
Voluntary.
Burden to the Public
• Allergy Treatment Form
(a) Estimated number of Applicants/
physicians: 100/100.
(b) Frequency of response: one time.
(c) Estimated average burden per
response: 20 minutes/10 minutes.
(d) Estimated total reporting burden:
33.3 hours/16.7 hours.
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72125
(e) Estimated annual cost to
respondents: Indeterminate.
General Description of Collection:
When an Applicant reports that he or
she is currently receiving allergy shot
treatments, Peace Corps provides the
Applicant with an Allergy Treatment
Form for his or her treating physician to
complete. The Peace Corps is not able
to arrange for Volunteers to receive
allergy shots during their Peace Corps
service. Peace Corps Volunteers
generally serve in areas that are isolated
and have limited access to Westerntrained providers and health care
systems. The Applicant completes the
form after discussing with his or her
physician whether the Applicant will be
able to live overseas for 27 months of
Peace Corps service without receiving
allergy shots. The Applicant is required
to certify that the Applicant has
discussed stopping allergy shots with
his or her physician and that the
physician agrees that the allergy shots
can be stopped without unreasonable
risk of substantial harm to the
Applicant’s health.
• Asthma Evaluation Form
(a) Estimated number of Applicants/
physicians: 500/500.
(b) Frequency of response: One time.
(c) Estimated average burden per
response: 75 minutes/30 minutes.
(d) Estimated total reporting burden:
625 hours/250 hours.
(e) Estimated annual cost to
respondents: Indeterminate.
General Description of Collection:
When an Applicant reports on the
Health History Form symptoms of
moderate persistent or severe persistent
asthma in the past two years, he or she
is provided an Asthma Evaluation Form
for the treating physician to complete.
The determination of whether the
reported symptoms indicate moderate
persistent or severe persistent asthma is
based on recognized classifications of
asthma severity. The Asthma Evaluation
Form asks for the physician to
document the Applicant’s condition of
asthma, including any asthma
symptoms, triggers, treatments, or
limitations or restrictions due to the
condition, as well as to certify that the
Applicant can safely serve 27 months
overseas. This form is used as the basis
for an individualized determination as
to whether the Applicant will, with
reasonable accommodation, be able to
meet the essential eligibility
requirements for a Peace Corps
Volunteer and complete a tour of service
without undue disruption due to health
problems. This form is also used to
determine the type of accommodation
that may be needed, such as placement
E:\FR\FM\02DEN1.SGM
02DEN1
]]>Agencies
[Federal Register Volume 78, Number 231 (Monday, December 2, 2013)]
[Notices]
[Pages 72124-72125]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-28732]
-----------------------------------------------------------------------
PEACE CORPS
Information Collection Request; Submission for OMB Review
AGENCY: Peace Corps.
ACTION: 60-day notice and request for comments.
-----------------------------------------------------------------------
SUMMARY: The Peace Corps will be submitting the following information
collection request to the Office of Management and Budget (OMB) for
review and approval. The purpose of this notice is to allow 60 days for
public comment in the Federal Register preceding submission to OMB. We
are conducting this process in accordance with the Paperwork Reduction
Act of 1995 (44 U.S.C. Chapter 35).
DATES: Comments must be submitted on or before January 31, 2014.
ADDRESSES: Comments should be addressed to Denora Miller, FOIA/Privacy
Act Officer. Denora Miller can be contacted by telephone at 202-692-
1236 or email at pcfr@peacecorps.gov. Email comments must be made in
text and not in attachments.
FOR FURTHER INFORMATION CONTACT: Denora Miller at Peace Corps address
above.
SUPPLEMENTARY INFORMATION:
Method: The Health History Form will be completed online in an
interactive process in which only questions relevant to each
Applicant's medical history (based on responses to previous questions)
are presented.
Title: Peace Corps Volunteer Health History Form (PC 1789).
OMB Control Number: 0420-0510.
Type of Request: Extension without change of a currently approved
collection.
Affected Public: Individuals.
Respondents Obligation to Reply: Voluntary.
Burden to the Public:
a. Estimated number of respondents: 10,000.
b. Estimated average burden per response: 45 minutes.
c. Frequency of response: one time.
d. Annual reporting burden: 7,500 hours.
e. Estimated annual cost to respondents: Indeterminate.
General Description of Collection: The Peace Corps Act requires
that Volunteers receive health examinations prior to their service. The
information collected is required for consideration for Peace Corps
Volunteer service. The Health History Form is used to document the
medical history of each individual Applicant. It is a self-report of
pre-existing medical conditions and
[[Page 72125]]
is used to help determine whether the Applicant will, with reasonable
accommodation, be able to perform the essential functions of a Peace
Corps Volunteer and complete a tour of service without undue disruption
due to health problems.
Request For Comment: Peace Corps invites comments on whether the
proposed collections of information are necessary for proper
performance of the functions of the Peace Corps, including whether the
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 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.
This notice is issued in Washington, DC on November 21, 2013.
Denora Miller,
FOIA/Privacy Act Officer, Management.
[FR Doc. 2013-28732 Filed 11-29-13; 8:45 am]
BILLING CODE 6051-01-P
