Information Collection

National Inmate Survey, 2010

IC 186487 under ICR 201003-1121-007 · OMB 1121-0311.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0311 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form D National Inmate Survey, 2010	Form
PAPI National Inmate Survey Natl Inmate Survey_PAPI_M12_v3.pdf	Form and Instruction
NIS-FQ-1 NIS Facility Questionnaire FacilitySurvey1.pdf	Form and Instruction
NIS - Pilot National Inmate Survey: Year 3 Pilot Draft Year 3 NIS.doc	Form and Instruction
D NIS PAPI D_NIS_PAPI_MArrive[1].pdf	Form
NIS PAPI M NIS PAPI M D_NIS_PAPI_M12[1].pdf	Form
NIS PAPA Arrive NIS PAPI Arrive D_NIS_PAPI_FArrive[1].pdf	Form
NIS PAPI F12 NIS PAPI F12 D_NIS_PAPI_F12[1].pdf	Form
No Number A NIS Questionnaire Revised_A_NISQuestionnaire (2).doc	Form
No Number National Inmate Survey Year 3 Alt Revised_B_NIS_AltQuestionniare (2).doc	Form
ItemChangesPREA.doc Item Changes	IC Document
G_ACASI_Juvenile_Consent_Card[1].doc Juvenile Consent Card	IC Document
E_ACASI_Consent_Form[1].doc ACASI Consent Form	IC Document
F_ACASI_Consent_Card[1].doc ACASI Concent Card	IC Document
C_NIS_PAPIConsent[1].doc NIC PAPI Consent	IC Document
H_MCVerification[1].doc Mental Verification	IC Document

IC Title:

National Inmate Survey, 2010

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	D	NIS PAPI	D_NIS_PAPI_MArrive[1].pdf	Yes	Yes	Fillable Fileable
Form	NIS PAPI M	NIS PAPI M	D_NIS_PAPI_M12[1].pdf	Yes	Yes	Fillable Fileable
Form	NIS PAPA Arrive	NIS PAPI Arrive	D_NIS_PAPI_FArrive[1].pdf	Yes	Yes	Fillable Fileable
Form	NIS PAPI F12	NIS PAPI F12	D_NIS_PAPI_F12[1].pdf	Yes	Yes	Fillable Fileable
Form and Instruction	NIS-FQ-1	NIS Facility Questionnaire	FacilitySurvey1.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	NIS - Pilot	National Inmate Survey: Year 3 Pilot	Draft Year 3 NIS.doc	Yes	Yes	Fillable Fileable
Form and Instruction	PAPI	National Inmate Survey	Natl Inmate Survey_PAPI_M12_v3.pdf	No		Printable Only
Form	No Number	National Inmate Survey Year 3 Alt	Revised_B_NIS_AltQuestionniare (2).doc	Yes	Yes	Fillable Fileable
Form	No Number	A NIS Questionnaire	Revised_A_NISQuestionnaire (2).doc	Yes	Yes	Fillable Fileable

Line of Business: Correctional Activities

Subfunction: Criminal Incarceration

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 105,500

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	105,500	105,500
Annual IC Time Burden (Hours)	63,681	63,681
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Item Changes	ItemChangesPREA.doc	08/26/2009
Juvenile Consent Card	G_ACASI_Juvenile_Consent_Card[1].doc	03/24/2010
ACASI Consent Form	E_ACASI_Consent_Form[1].doc	03/24/2010
ACASI Concent Card	F_ACASI_Consent_Card[1].doc	03/24/2010
NIC PAPI Consent	C_NIS_PAPIConsent[1].doc	03/24/2010
Mental Verification	H_MCVerification[1].doc	03/24/2010

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