Information Collection

NCVS Mode Study

IC 194811 under ICR 200904-1121-002 · OMB 1121-0325.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0325 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NCVS 1 NCVS Mode Study	Form and Instruction
NCVS 1 NCVS 1 Screener IVR Attachment 6 IVR Script - NCVS-1.doc	Form and Instruction
NCVS 2 NCVS 2 Crime Incident Report IVR Attachment 8 IVR Script- NCVS-2.doc	Form and Instruction
Attachment 2 AdFlyer_crime and not crime victims.doc Advertisement Flyer	IC Document
Attachment 14 FAQs.doc FAQs	IC Document
Attachment 13 Letters.doc Invitation and Refusal Letter	IC Document
Attachment 10 Hotline Numbers.doc Hotline Numbers	IC Document
Attachment 5 Research Consent Form.doc Consent Form	IC Document
Attachment 17 Research Consent Form_Focus Groups.doc Focus Group Consent Form	IC Document
Attachment 3 Recruitment Screener.doc Recruitment Screener	IC Document
Attachment 15 Crime Facts.doc Crime Facts	IC Document
Attachment 16 Inserts.doc Inserts	IC Document
Attachment 12 Focus Group Protocol.doc Focus Group Protocol	IC Document
Attachment 11 Debriefing Protocol_At-Home Session.doc Debriefing Protocol At-Home Session	IC Document
Attachment 1 Project Summary.doc Project Summary	IC Document
Attachment 9 Protocol Debreifing for NCVS-2.doc Protocol Debriefing For NCVS 2	IC Document
Attachment 4 Crime Scenarios.doc Crime Senarios	IC Document
Attachment 7 Protocol Debriefing for NCVS-1.doc Protocol Debriefing for NCVS 1	IC Document
Memo on behavior coding and comprehension probes, 12-6-10.docx Justification Memo	IC Document

IC Title:

NCVS Mode Study

Agency IC Tracking Number:

BJS

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NCVS 1	NCVS 1 Screener IVR	Attachment 6 IVR Script - NCVS-1.doc		Yes	Yes	Fillable Fileable
Form and Instruction	NCVS 2	NCVS 2 Crime Incident Report IVR	Attachment 8 IVR Script- NCVS-2.doc		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 280

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
Annual Number of Responses for this IC	280	280
Annual IC Time Burden (Hours)	120	120
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Advertisement Flyer	Attachment 2 AdFlyer_crime and not crime victims.doc	10/07/2010
FAQs	Attachment 14 FAQs.doc	10/07/2010
Invitation and Refusal Letter	Attachment 13 Letters.doc	10/07/2010
Hotline Numbers	Attachment 10 Hotline Numbers.doc	10/07/2010
Consent Form	Attachment 5 Research Consent Form.doc	10/07/2010
Focus Group Consent Form	Attachment 17 Research Consent Form_Focus Groups.doc	10/07/2010
Recruitment Screener	Attachment 3 Recruitment Screener.doc	10/07/2010
Crime Facts	Attachment 15 Crime Facts.doc	10/07/2010
Inserts	Attachment 16 Inserts.doc	10/07/2010
Focus Group Protocol	Attachment 12 Focus Group Protocol.doc	10/07/2010
Debriefing Protocol At-Home Session	Attachment 11 Debriefing Protocol_At-Home Session.doc	10/07/2010
Project Summary	Attachment 1 Project Summary.doc	10/07/2010
Protocol Debriefing For NCVS 2	Attachment 9 Protocol Debreifing for NCVS-2.doc	10/07/2010
Crime Senarios	Attachment 4 Crime Scenarios.doc	10/07/2010
Protocol Debriefing for NCVS 1	Attachment 7 Protocol Debriefing for NCVS-1.doc	10/07/2010
Justification Memo	Memo on behavior coding and comprehension probes, 12-6-10.docx	12/13/2010

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