Information Collection

PACT 360 Needs Assessment Survey Instrument

IC 197974 under ICR 201106-1103-002 · OMB 1103-0108.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PACT 360 Needs Assessment Survey Instrument	Form and Instruction
COPSNEEDSASSESSMENT_9_9_webversion.pdf	Form and Instruction
RevisionOverview_Design.pdf Design Overview	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	None	COPSNEEDSASSESSMENT_9_9_webversion.pdf		Yes	Yes	Fillable Printable

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	75	75
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Design Overview	RevisionOverview_Design.pdf	09/14/2011

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