Revised 83i

PAPERWORK REDUCTION ACT SUBMISSION
Please read the instructions before completing this form. For additional forms or assistance in completing this form, contact your
agency's Paperwork Clearance Officer. Send two copies of this form, the collection instrument to be reviewed, the Supporting
Statement, and any additional documentation to: Office of Information and Regulatory Affairs, Office of Management and Budget,
Docket Library, Room 10102, 725 17th Street NW, Washington, DC 20503.
2. OMB CONTROL NUMBER

1. AGENCY/SUBAGENCY ORIGINATING REQUEST

U.S. Department of Justice/Bureau of Justice Statistics (BJS)
a.

0111

b. NONE

4. TYPE OF REVIEW REQUESTED (X one)

3. TYPE OF INFORMATION COLLECTION (X one)

X
a. NEW COLLECTION

a. REGULAR SUBMISSION
b. EMERGENCY - APPROVAL REQUESTED BY:

b. REVISION OF A CURRENTLY APPROVED COLLECTION

X

1121

c. DELEGATED

c. EXTENSION OF A CURRENTLY APPROVED COLLECTION
d. REINSTATEMENT, WITHOUT CHANGE, OF A PREVIOUSLY
APPROVED COLLECTION FOR WHICH APPROVAL HAS EXPIRED

5. SMALL ENTITIES
Will this information collection have a significant economic
impact on a substantial number of small entities?

e. REINSTATEMENT, WITH CHANGE, OF A PREVIOUSLY
APPROVED COLLECTION FOR WHICH APPROVAL HAS EXPIRED

YES
X NO
6. REQUESTED EXPIRATION DATE

X

f. EXISTING COLLECTION IN USE WITHOUT AN OMB CONTROL
NUMBER

a. THREE YEARS FROM APPROVAL DATE
b. OTHER:

7. TITLE

National Crime Victimization Survey
8. AGENCY FORM NUMBER(S) (if applicable)
NCVS-110, NCVS-550.1, NCVS-554 Mailed Letters: NCVS-572(L), NCVS-572(L)SP, NCVS-572(L)CHIN-M, NCVS-572(L)CHIN-T, NCVS-572(L)KOR,
NCVS-572(L)VIET, NCVS-573(L), NCVS-573(L)SP, NCVS-593(L), NCVS-593(L)SP, NCVS-594(L), NCVS-594(L)SP
9. KEYWORDS
CRIME in the U.S.

10. ABSTRACT
The National Crime Victimization Survey collects, analyzes, publishes, and disseminates statistics on the amount and type of crime committed against households
and individuals in the U.S. Respondents include persons 12 years of age or older living in NCVS sampled households located throughout the United States.

11. AFFECTED PUBLIC (Mark primary with "P" and all others that apply with "X")
P

a. INDIVIDUALS OR HOUSEHOLDS

P

e. FEDERAL GOVERNMENT

c. NOT-FOR-PROFIT INSTITUTIONS

f. STATE, LOCAL OR TRIBAL GOVERNMENT

a. NUMBER OF RESPONDENTS
b. TOTAL ANNUAL RESPONSES
(1) Percentage of these responses collected electronically
c. TOTAL ANNUAL HOURS REQUESTED
d. CURRENT OMB INVENTORY
e. DIFFERENCE (+, -)
EXPLANATION OF
DIFFERENCE:

(1) Program change (+, -)

100,700
201,400
100
68,905
67,657
1,248
1,248

c. TOTAL ANNUALIZED COST REQUESTED
d. CURRENT OMB INVENTORY
e. DIFFERENCE (+, -)
f.

d. AUDIT

17. STATISTICAL METHODS
Does this information collection employ
statistical methods?
X

YES

OMB FORM 83-I, 10/95

NO

EXPLANATION OF DIFFERENCE:
(1) Program change (+, -)

16. FREQUENCY OF RECORDKEEPING OR REPORTING (X all that apply)
a. RECORDKEEPING

b. PROGRAM EVALUATION

X

0.00

b. TOTAL ANNUAL COSTS (O&M)

(2) Adustment (+, -)

e. PROGRAM PLANNING
OR MANAGEMENT

c. GENERAL PURPOSE STATISTICS

c. MANDATORY

a. TOTAL CAPITAL/STARTUP COSTS

"P" and all others that apply with "X")
a. APPLICATION FOR BENEFITS

others that apply with "X")

14. ANNUALIZED COST TO RESPONDENTS (In thousands of dollars)

(2) Adustment (+, -)

15. PURPOSE OF INFORMATION COLLECTION (Mark primary with

P

a. VOLUNTARY

b. REQUIRED TO OBTAIN OR RETAIN BENEFITS

b. BUSINESS OR OTHER FOR-PROFIT

13. ANNUAL REPORTING AND RECORDKEEPING HOUR BURDEN

f.

12. OBLIGATION TO RESPOND (Mark primary with "P" and all

d. FARMS

X

f. RESEARCH
g. REGULATORY OR
COMPLIANCE

b. THIRD PARTY DISCLOSURE

c. REPORTING:
(1) On Occasion
(4) Quarterly
(7) Biennially

X

(2) Weekly

(3) Monthly

(5) Semi-Annually

(6) Annually

(8) Other (Describe)

18. AGENCY CONTACT (Person who can best answer questions regarding the content of this
submission)
a. NAME

Michael Planty, BJS

b. TELEPHONE NUMBER (Include area code)

202-514-9746