Information Collection

Defense Criminal Incident Reporting System Records

IC 204975 under ICR 201211-0704-006 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DLA Form 1622 Defense Criminal Incident Reporting System Records	Form
DLA Form 1622 Rights Warning Procedure and Waiver Certificate DL1622, Rights Warning Procedure and Waiver Certificate.pdf	Form
DLA Form 1623 Sworn Statement DL1623, Sworn Statement.pdf	Form
DLA Form 1624A Evidence Custody Document DL1624A.pdf	Form
DLA 1753 Interview Work Sheet DL1753 Interview Work Sheet.pdf	Form

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	Available Electronically?	Electronic Capability
Form	DLA Form 1622	Rights Warning Procedure and Waiver Certificate	DL1622, Rights Warning Procedure and Waiver Certificate.pdf	No	Paper Only
Form	DLA Form 1623	Sworn Statement	DL1623, Sworn Statement.pdf	No	Paper Only
Form	DLA Form 1624A	Evidence Custody Document	DL1624A.pdf	No	Paper Only
Form	DLA 1753	Interview Work Sheet	DL1753 Interview Work Sheet.pdf	No	Paper Only

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	1,000	1,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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