83i

1110-0015 OMB 83i.wpd

Hate Crime Incident Report and Quarterly Hate Crime Report

83I

OMB: 1110-0015

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PAPERWORK REDUCTION ACT SUBMISSION

Please read the instructions before completing this form. For additional forms or assistance in completing this form contact your agency's Paperwork Clearance Officer. Send two copies of this form, the collection instrument to be reviewed, the Supporting Statement, and any additional documentation to: Office of Information and Regulatory Affairs, Office of Management and Budget, Docket Library, Room 10102, 72 17th Street NW, Washington, DC 20503.

1. Agency/Subagency originating request

DOJ, FBI, CJIS

2.OMB control numberb. □ None

a. 1 1 1 0 - 0 0 15__ __ __ __

3.Type of information collection (check one)

a. New collection

b. Revision of a currently approved collection

c. __Extension of a currently approved collection

d. Reinstatement, without change, of a previously approved

collection for which approval has expired

e. Reinstatement, with change, of a previously approved

collection for which approval has expired

f. Existing collection in use without an OMB control number



3a. Public Comments

Has the agency received public comments on this information collection?

Yes No

4.Type of review requested (check one)

a. Regular

b. Emergency - Approval requested by: ___/___/___

c. Delegated

5.Small entities

Will this information collection have significant economic impact

on a substantial number of small entities? Yes No

6.Requested expiration date

a. Three years from the approval date

b. Other Specify: ____/____

7.Title Hate Crime Incident Report and Quarterly Hate Crime Report

8.Agency form number(s) (if applicable) 1-699, 1-700

9.Keywords Hate Crimes, Bias Motivated Offenses

10.Abstract These forms provide specific data related to bias-motivated criminal offenses. The resulting data are published annually.

11.Affected public (Mark primary with "P" and all others that apply with "X")

a. Individuals or householdsd. Farms

b. Business or other for profit e. X Federal Government

c. Not-for-profit institutionsf. PState, Local, or Tribal Government

12.Obligation to respond (Mark primary with "P" and all others that apply with "X")

a. P Voluntary

b. Required to obtain or retain benefits

c. Mandatory

13.Annual reporting and recordkeeping hour burden

a.Number of respondents 13,242

b.Total annual responses 52,968

1.Percentage of these responses

collected electronically 73%

c.Total annual hours requested 7,945

d.Current OMB Inventory 7,945

e.Difference 0

f.Explanation of difference

1.Program Change

2.Adjustment 0

14.Annual reporting and recordkeeping cost burden (in thousands of dollars)

a.Total annualized capital/startup costs 0

b.Total annual costs (O&M) 0

c.Total annualized cost requested 0

d.Current OMB Inventory 0

e.Difference 0

f.Explanation of difference

1.Program Change

2.Adjustment 0

15.Purpose of information collection (Mark primary with "P" and all others

that apply with "X")

a. Application for benefitse. Program planning or management

b. Program Evaluation f. X Research

c. PGeneral Purpose Statisticsg. Regulatory or Compliance

d. Audit

16.Frequency of recordkeeping or reporting (check all that apply)

a. Recordkeepingb. Third Party Disclosure

c. Reporting

1.On occasion2.Weekly3.Monthly

4.Quarterly5.Semi-annually6.Annually

7.Biennially8.Other (describe) ____________

17.Statistical Methods

Does this Information Collection employ statistical methods?


YesNo


18.Agency contact (person who can best answer questions regarding the content of

this submission)


Name:Patricia S. Hanning


Phone: (304) 625-2957


OMB 83-I 10/95

19. Certification for Paperwork Reduction Act Submissions



On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with

5 CFR 1320.9.



NOTE: The text of 5 CFR 1320.9, and the related provisions of 5 CFR 1320.8(b)(3), appear at the end of the

instructions. The certification is to be made with reference to those regulatory provisions as set forth in

the instructions.



The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:


(a)It is necessary for the proper performance of agency functions;

(b)It avoids unnecessary duplication;

(c)It reduces burden on small entities;

(d)It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e)Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f)It indicates the retention periods for recordkeeping requirements;

(g)It informs respondents of the information called for under 5 CFR 1320.8(b)(3) about:

(i)Why the information is being collected;

(ii)Use of information;

(iii)Burden of estimate;

(iv)Nature of response (voluntary, required for benefit, or mandatory);

(v)Nature and extent of confidentiality; and

(vi)Need to display currently valid OMB control number;

(h)It was developed by an office that has planned and allocated resources for the efficient and effective

management and use of the information to be collected (see note in Item 19 of the instructions);

(i)It uses effective and efficient statistical survey methodology (if applicable); and

(j)It makes appropriate use of information technology.




If you are unable to certify compliance with any of these provisions, identify the item below and explain the reason in

Item 18 of the Supporting Statement.









Signature of Senior Official or designee




Date

OMB 83-I 10/95

File Typeapplication/octet-stream
File Modified0000-00-00
File Created0000-00-00

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