Information Collection

National Crime Victimization Survey

IC 12401 under ICR 200805-1121-003 · OMB 1121-0111.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0111 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NCVS-554(SP) National Crime Victimization Survey	Form
emotional impact.doc	Other-Emotional toll questions to be
NCVS-554(SP) National Crime Victimization Survey 554 Spanish NCVS554_Spanish.pdf	Form
NCVS-500 National Crime Victimization Survey 500 NCVS_500.pdf	Form
NCVS-1(SP) National Crime Victimization Survey 1 Spanish NCVS_1(SP).pdf	Form
NCVS-1A National Crime Victimization Survey 1A NCVS_1A.pdf	Form
NCVS-2(SP) National Crime Victimization Survey 2 (SP) NCVS-2 (SP).pdf	Form
NCVS-594 National Crime Victimization Survey 594 spanish NCVS-594 (SP).pdf	Form
NCVS-1 National Crime Victimization Survey 1 NCVS-1_9162004.pdf	Form
NCVS-2 National Crime Victimization Survey 2 ncvs2_with_pregnancy_July_2005.pdf	Form
NCVS-7 National Crime Victimization Survey 7 NCVS-7.pdf	Form
NCVS-554 National Crime Victimization Survey 554 NCVS-554_2006.pdf	Form
NCVS-541 National Crime Victimization Survey 541 NCVS-541 REINTERVIEW BASIC SCREEN QUESTIONNAIRE.pdf	Form
NCVS-545 National Crime Victimization Survey 545 NCVS-545 REINTERVIEW QUESTIONNAIRE FOR ORIGINAL SURVEY NONINTERVIEWS (TYPE A AND B).pdf	Form
NCVS_2 additional National Crime Victimization Survey - 2 (additional ques Screen Shots - New Disability Section Jan 2007.doc	Form
ncvs572L (Dallas) 10-2005.pdf NCVS-572 letter	IC Document
NCVS_593.pdf NCVS-593 letter	IC Document
NCVS-593 (SP).pdf NCVS-593 letter in spanish	IC Document
NCVS-573.pdf NCVS-573 letter	IC Document
NCVS_594.pdf NCVS-594 letter	IC Document
NCVS-594 (SP).pdf NCVS-594 letter spanish	IC Document
NCVS-110 FACT_Sheet_2004.pdf NCVS-110 fact sheet	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

National Crime Victimization Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NCVS-554(SP)	National Crime Victimization Survey 554 Spanish	NCVS554_Spanish.pdf	Yes	Yes	Fillable Fileable
Form	NCVS-500	National Crime Victimization Survey 500	NCVS_500.pdf	Yes	Yes	Fillable Fileable
Form	NCVS-1(SP)	National Crime Victimization Survey 1 Spanish	NCVS_1(SP).pdf	Yes	Yes	Fillable Fileable
Form	NCVS-1A	National Crime Victimization Survey 1A	NCVS_1A.pdf	Yes	Yes	Fillable Fileable
Form	NCVS-2(SP)	National Crime Victimization Survey 2 (SP)	NCVS-2 (SP).pdf	Yes	Yes	Fillable Fileable
Form	NCVS-594	National Crime Victimization Survey 594 spanish	NCVS-594 (SP).pdf	Yes	Yes	Fillable Fileable
Form	NCVS-1	National Crime Victimization Survey 1	NCVS-1_9162004.pdf	Yes	Yes	Fillable Fileable
Form	NCVS-2	National Crime Victimization Survey 2	ncvs2_with_pregnancy_July_2005.pdf	Yes	Yes	Fillable Fileable
Form	NCVS-7	National Crime Victimization Survey 7	NCVS-7.pdf	Yes	Yes	Fillable Fileable
Form	NCVS-554	National Crime Victimization Survey 554	NCVS-554_2006.pdf	Yes	Yes	Fillable Fileable
Form	NCVS-541	National Crime Victimization Survey 541	NCVS-541 REINTERVIEW BASIC SCREEN QUESTIONNAIRE.pdf	Yes	Yes	Fillable Fileable
Form	NCVS-545	National Crime Victimization Survey 545	NCVS-545 REINTERVIEW QUESTIONNAIRE FOR ORIGINAL SURVEY NONINTERVIEWS (TYPE A AND B).pdf	Yes	Yes	Fillable Fileable
Form	NCVS_2 additional questions	National Crime Victimization Survey - 2 (additional questions	Screen Shots - New Disability Section Jan 2007.doc	Yes	No	Fillable Printable
Other-Emotional toll questions to be added			emotional impact.doc	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 66,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	133,000	-21,000	154,000
Annual IC Time Burden (Hours)	53,824	-8,796	62,620
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NCVS-572 letter	ncvs572L (Dallas) 10-2005.pdf	01/10/2007
NCVS-593 letter	NCVS_593.pdf	01/10/2007
NCVS-593 letter in spanish	NCVS-593 (SP).pdf	01/10/2007
NCVS-573 letter	NCVS-573.pdf	01/10/2007
NCVS-594 letter	NCVS_594.pdf	01/10/2007
NCVS-594 letter spanish	NCVS-594 (SP).pdf	01/10/2007
NCVS-110 fact sheet	NCVS-110 FACT_Sheet_2004.pdf	01/11/2007

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.