Information Collection

Clinical Indicators of Sexual Violence in Correctional Facilities Pilot Study

IC 187042 under ICR 201003-1121-003 · OMB 1121-0324.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Clinical Indicators of Sexual Violence in Correctional Facilities Pilot Study	Form
Clinical Indicators of Sexual Violence in Custody Attachment 3. Surveillance Form.doc	Form

IC Title:

Agency IC Tracking Number:

BJS

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	None	Clinical Indicators of Sexual Violence in Custody	Attachment 3. Surveillance Form.doc		No		Printable Only

Line of Business: Correctional Activities

Subfunction: Criminal Incarceration

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 35

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 20 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,435	0	1,435
Annual IC Time Burden (Hours)	0	-383	383
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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