Bernice Heiderman Memorial Fund
(So we can send you a tax receipt)
NOTE: We use Pay.gov as our trusted secure payment processor. We’ll send you on to there and bring you back when you finish.
OMB no. 0420-0564
Expiration date: 11/30/2020
This is a Secure Transaction
The secure server software (SSL) that processes Peace Corps donations is the industry standard and among the best software available today for secure commerce transactions. It encrypts all of your personal data including credit card number, name, and address, so that it cannot be read as the information travels over the Internet. You can tell when you are protected by encryption — the lock or key at the bottom of your browser changes color or is no longer broken.
Public reporting burden for this collection of information is estimated to average 10 minutes per response. This includes the time for reviewing instructions and completing the information. This is voluntary information collection. An agency may not conduct or sponsor, and persons are not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: the FOIA/Privacy Officer, Peace Corps, 1275 First Street NE, Washington, DC 20526.
Privacy Act Notice
This information is being collected pursuant to 22 U.S.C. 2501(a). This information will be used in processing your donation to the Peace Corps. Disclosure of this information is voluntary. Failure to provide sufficient information may preclude your receipt of a tax acknowledgement letter. This information may be used for the routine uses described in the Privacy Act, 5 U.S.C. 552a, and the Peace Corps' published Routine Uses, A through M, listed on the Privacy page at https://www.peacecorps.gov/about/privacy/#routine-uses for System of Records PC-10 Office of Private Sector Initiatives Database.