COPS Police and Communities Together (PACT) 360 Needs Assessment Survey

Forms and Documents

Document Name	Status
PACT 360 Needs Assessment Survey Instrument Form and Instruction	New
Supporting_Statement_Part_B_9_9_cleanrevision.pdf Supporting Statement B	2011-09-14
Supporting_Statement_Part_A_9-9 _cleanrevision.pdf Supporting Statement A	2011-09-14

IC Document Collections

IC ID	Document Title	Status
197974	PACT 360 Needs Assessment Survey Instrument Form and Instruction	New

ICR Details

OMB Control No: 1103-0108	ICR Reference No: 201106-1103-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOJ/DOJADM	Agency Tracking No:
Title: COPS Police and Communities Together (PACT) 360 Needs Assessment Survey
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/14/2011
	Date Received in OIRA: 06/15/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2014	36 Months From Approved
Responses	300	0	0
Time Burden (Hours)	75	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Under the Violent Crime and Control Act of 1994, the U.S. Department of Justice COPS Office would request the completion of the Police and Communities Together (PACT) 360 Needs Assessment Survey from law enforcement agencies and substance abuse prevention and treatment providers in order to improve the delivery of substance abuse prevention programs to parents and teens in U.S. communities.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: PL: Pub.L. 103 - 322 10003 Name of Law: Violent Crime and Control Act of 1994

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 17151	03/28/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 31988	06/02/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
PACT 360 Needs Assessment Survey Instrument	None	None

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ICR Summary of Burden

	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	300	0	0	300	0	0
Annual Time Burden (Hours)	75	0	0	75	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The burden on the public will be minimal. The total time to complete the survey will be approximately 15 minutes. Up to 300 individuals will be recruited to participate in the survey, which will be weighted to include at least 150 law enforcement officers. The remainder of the participants will consist of treatment and prevention providers, and educators. This is a one-time survey. No respondent will take the survey more than once.

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Annual Cost to Federal Government: $9,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(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 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;

(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.

(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 by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/15/2011

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