Information Collection

Stress Resiliency Survey Battery

IC 206576 under ICR 201305-1103-003 · OMB 1103-0113.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1103-0113 can be found here:

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: Modified

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 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

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 Agency Discretion
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	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.