Public Safety Officer Medal of Valor Application

ICR 200304-1121-005

OMB: 1121-0259

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
38364 Migrated
ICR Details
1121-0259 200304-1121-005
Historical Active 200210-1121-001
DOJ/OJP
Public Safety Officer Medal of Valor Application
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 04/09/2003
Retrieve Notice of Action (NOA) 04/09/2003
  Inventory as of this Action Requested Previously Approved
12/31/2005 12/31/2005 12/31/2005
500 0 500
500 0 500
0 0 0

This application will be used to recommend candidates for the Public Safety Officer Medal of Valor award. This honor is awarded to a public safety officer who has exhibited exceptional valor, extraordinary decisiveness, presence of mind, and an unusual swiftness of action, regardless of his or her own personal safety. In the attempt to save or protect human life. This act is deemed to be above and beyound the call of duty.

None
None


No

1
IC Title Form No. Form Name
Public Safety Officer Medal of Valor Application OJP-1673/1

  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 500 500 0 0 0 0
Annual Time Burden (Hours) 500 500 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
04/09/2003


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