Application for Public Safety Officers' Educational Assistance

ICR 201003-1121-004

OMB: 1121-0220

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Unchanged
Supporting Statement A
2010-03-16
Supplementary Document
2007-01-18
IC Document Collections
ICR Details
1121-0220 201003-1121-004
Historical Active 200610-1121-001
DOJ/OJP
Application for Public Safety Officers' Educational Assistance
Extension without change of a currently approved collection   No
Regular
Approved without change 05/05/2010
Retrieve Notice of Action (NOA) 03/24/2010
  Inventory as of this Action Requested Previously Approved
05/31/2013 36 Months From Approved 05/31/2010
78 0 78
26 0 26
0 0 0

The agency requires the information requested on this application to determine if individuals are eligible to receive educational assistance through the Public Safety Officers' Educational Assistance (PSOEA) Program, as established by the PSOEA Act of 1998 (P.L. 104-238). Respondents who complete the application may be spouses or eligible children of public safety officers who were killed or permanently and totally disabled in the line of duty.

PL: Pub.L. 104 - 238 1211 Name of Law: Public Safety Officer's Benefits
  
None

Not associated with rulemaking

  75 FR 1812 01/13/2010
75 FR 14185 03/24/2010
No

1
IC Title Form No. Form Name
Application for Public Safety Officers' Educational Assistance None PSOBEA

  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 78 78 0 0 0 0
Annual Time Burden (Hours) 26 26 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$668
No
Yes
Uncollected
Uncollected
No
Uncollected
Maria Pressley 202-353-8643 [email protected]

  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.
03/24/2010


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