Deaths in Custody -- series of collections from local jails, State prisons and juvenile detention centers, and law enforcement

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0249 can be found here:

Documents and Forms

Document Name Document Type
Form NPS-4 Deaths in Custody -- series of collections from local jails, State prisons and juvenile detention centers, and law enforcement Form
NPS-4 Quarterly Summary of Inmate Deaths in State Prision NPS-4 2009-final_2.pdf Form
NPS-4A Annual State Prision Inmate Death Report NPS-4A 2009-final_2.pdf Form
CJ-9 Quarterly Report on Inmates under Jail Jurisdiction CJ-9 2009-final_2.pdf Form
CJ-9A Annual Summary on Inmates under Jail Jurisdiction CJ-9a 2009-final_2.pdf Form
CJ-10 Quarterly Report on Inmates in Private and Multi-Jurisdi CJ-10 2009-final_2.pdf Form
CJ-10A Annual Summary on Inmates in Private and Multi-Jurisdict CJ-10a 2009-final_2.pdf Form
CJ-11 Quarterly Summary of Deaths in Law Enforcement Custody CJ-11 2009 final_2.pdf Form
CJ-11A Arrested Related Death Report cj11a 101410.pdf Form
CJ-9-instructions-2009 (2).doc Local Jails IC Document
CJ-11-2009-instructions (2).doc State and Local Law Enforcement IC Document
NPS-4A-instructions (3).doc State Prison IC Document
CJ-11A-2009-instructions.doc State and Local Law Enforcement Addendum IC Document
mcdsp04.pdf Medical Causes of Death in State Prison, 2001-2004 IC Document
DCRP-online data tables-10-21-09.pdf DCRP Data Tables IC Document
DCRP-OMB-Attatch E-letter.docx Introduction letter IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Deaths in Custody -- series of collections from local jails, State prisons and juvenile detention centers, and law enforcement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NPS-4	Quarterly Summary of Inmate Deaths in State Prision	NPS-4 2009-final_2.pdf	Yes	Yes	Fillable Fileable
Form	NPS-4A	Annual State Prision Inmate Death Report	NPS-4A 2009-final_2.pdf	Yes	Yes	Fillable Fileable
Form	CJ-9	Quarterly Report on Inmates under Jail Jurisdiction	CJ-9 2009-final_2.pdf	Yes	Yes	Fillable Fileable
Form	CJ-9A	Annual Summary on Inmates under Jail Jurisdiction	CJ-9a 2009-final_2.pdf	Yes	Yes	Fillable Fileable
Form	CJ-10	Quarterly Report on Inmates in Private and Multi-Jurisdiction Jails	CJ-10 2009-final_2.pdf	Yes	Yes	Fillable Fileable
Form	CJ-10A	Annual Summary on Inmates in Private and Multi-Jurisdiction Jails	CJ-10a 2009-final_2.pdf	Yes	Yes	Fillable Fileable
Form	CJ-11	Quarterly Summary of Deaths in Law Enforcement Custody	CJ-11 2009 final_2.pdf	Yes	Yes	Fillable Printable
Form	CJ-11A	Arrested Related Death Report	cj11a 101410.pdf	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,102	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 66 %

	Approved	Previously Approved
Annual Number of Responses for this IC	19,308	19,308
Annual IC Time Burden (Hours)	4,634	4,634
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Local Jails	CJ-9-instructions-2009 (2).doc	10/20/2009
State and Local Law Enforcement	CJ-11-2009-instructions (2).doc	10/20/2009
State Prison	NPS-4A-instructions (3).doc	10/20/2009
State and Local Law Enforcement Addendum	CJ-11A-2009-instructions.doc	10/20/2009
Medical Causes of Death in State Prison, 2001-2004	mcdsp04.pdf	10/21/2009
DCRP Data Tables	DCRP-online data tables-10-21-09.pdf	10/21/2009
Introduction letter	DCRP-OMB-Attatch E-letter.docx	10/22/2009

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