NCVS Companion Survey (CS)

Research to support the National Crime Victimization Survey (NCVS)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0325 can be found here:

Documents and Forms

Document Name Document Type
NCVS Companion Survey (CS) Form
NCVS-554_capi_info_booklet.pdf Instruction
Approach 2b screener Attachment E - Approach 2B Mail Screener - revised1.pdf Form
Survey of Neighborhoods Attachment F2 - Approach 2C Mail Screener (generic version) - revised1.pdf Form
Survey of Chicagoland Neighborhoods Attachment F1 - Approach 2C Mail Screener (local version) - revised1.pdf Form
Appendix Bundle.docx Appendix Bundle with Table of Contents IC Document
Attachment G - NCVS1 Core - Basic Screen Questionnaire.pdf Attachment G - Basic Screen Questionnaire IC Document
Attachment H - NCVS2 Core - Crime Incident Report.pdf Attachment H - NCVS2 Core - Crime Incident Report IC Document
BJS NCVS-CS test Q and A document.doc Passback Q and A IC Document
NCVS CS OMB Pilot Package_final2_21_rev1.docx Pilot Study Memorandum updated IC Document
Appendix Bundle - with Westat edits_rev1.docx Supplementary materials IC Document

Information Collection (IC) Details

IC Title:	NCVS Companion Survey (CS)	Agency IC Tracking Number:	BJS

IC Status: New

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	None	Approach 2b screener	Attachment E - Approach 2B Mail Screener - revised1.pdf	No		Paper Only
Form	None	Survey of Neighborhoods	Attachment F2 - Approach 2C Mail Screener (generic version) - revised1.pdf	No		Paper Only
Form	None	Survey of Chicagoland Neighborhoods	Attachment F1 - Approach 2C Mail Screener (local version) - revised1.pdf	No		Paper Only
Instruction			NCVS-554_capi_info_booklet.pdf	Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14,549	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	14,549	14,549
Annual IC Time Burden (Hours)	4,228	4,228
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix Bundle with Table of Contents	Appendix Bundle.docx	03/29/2012
Attachment G - Basic Screen Questionnaire	Attachment G - NCVS1 Core - Basic Screen Questionnaire.pdf	03/29/2012
Attachment H - NCVS2 Core - Crime Incident Report	Attachment H - NCVS2 Core - Crime Incident Report.pdf	03/29/2012
Passback Q and A	BJS NCVS-CS test Q and A document.doc	04/24/2012
Pilot Study Memorandum updated	NCVS CS OMB Pilot Package_final2_21_rev1.docx	04/24/2012
Supplementary materials	Appendix Bundle - with Westat edits_rev1.docx	04/24/2012

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