Information Collection

COPS Customer Outreach and Information Sample

IC 202168 under ICR 201205-1103-001 · OMB 1103-0109.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1103-0109 can be found here:

Documents and Forms

Document Name Document Type
Question Bank Screenshots 2.9.12.pdf Other-Questions answered electronica
Explanation for Generic IC Burden Worksheet for additional questions to Question Bank 2.17.12.docx Explanation for Generic IC Burden Hours IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	COPS Customer Outreach and Information Sample	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Questions answered electronically			Question Bank Screenshots 2.9.12.pdf		Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000	Number of Respondents for Small Entity: 300

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Explanation for Generic IC Burden Hours	Explanation for Generic IC Burden Worksheet for additional questions to Question Bank 2.17.12.docx	05/07/2012

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