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Stress Resiliency Survey Battery
Milwaukee Police Department Stress Resiliency Questionnaires
OMB: 1103-0113
IC ID: 206576
OMB.report
DOJ/DOJADM
OMB 1103-0113
ICR 201304-1103-001
IC 206576
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1103-0113 can be found here:
2013-09-09 - New collection (Request for a new OMB Control Number)
2013-05-20 - New collection (Request for a new OMB Control Number)
Documents and Forms
Document Name
Document Type
Stress Resiliency Survey Battery
Form and Instruction
Impact Events Scale
Impact Events Scale - BSL.pdf
Form and Instruction
Perceived Stress Scale
Perceived Stress Scale BSL.pdf
Form and Instruction
Person Organizational Quality Assessment
Person Organizational Quality Assessment BSL.pdf
Form and Instruction
Response to Stressful Experiences Scale
Response To Stressful Experiences Scale BSL.pdf
Form and Instruction
Vital Exhaustion Scale
Vital Exhaustion v2 BSL.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Stress Resiliency Survey Battery
Agency IC Tracking Number:
Is this a Common Form?
No
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
Form and Instruction
N/A
Impact Events Scale
Impact Events Scale - BSL.pdf
Yes
Yes
Fillable Printable
Form and Instruction
N/A
Perceived Stress Scale
Perceived Stress Scale BSL.pdf
Yes
Yes
Fillable Printable
Form and Instruction
N/A
Person Organizational Quality Assessment
Person Organizational Quality Assessment BSL.pdf
Yes
Yes
Fillable Printable
Form and Instruction
N/A
Response to Stressful Experiences Scale
Response To Stressful Experiences Scale BSL.pdf
Yes
Yes
Fillable Printable
Form and Instruction
N/A
Vital Exhaustion Scale
Vital Exhaustion v2 BSL.pdf
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Law Enforcement
Subfunction:
Crime Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
20
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
98 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
60
0
60
0
0
0
Annual IC Time Burden (Hours)
15
0
15
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.