Milwaukee Police Department Stress Resiliency Questionnaires

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Response to Stressful Experiences Scale BSL	Form and Instruction	Modified	Available
Vital Exhaustion BSL	Form and Instruction	Modified	Available
Person Organizational Quality Assessment_BSL	Form and Instruction	Modified	Available
Perceived Stress Scale_BSL	Form and Instruction	Modified	Available
Perceived Stress Scale_BS	Form and Instruction	Modified	Available
Supporting Statement Part B_Resubmittal_COPS_2012ckwxk002_Aug262013.doc	Supporting Statement B	Uploaded 2013-09-06	Available
Supporting Statement Part A_Resubmittal_COPS_2012ckwxk002_Aug262013.doc	Supporting Statement A	Uploaded 2013-09-06	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
206576	Stress Resiliency Survey Battery	Form and Instruction	Modified	Response to Stressful Experiences Scale BSL
206576	Stress Resiliency Survey Battery	Form and Instruction	Modified	Vital Exhaustion BSL
206576	Stress Resiliency Survey Battery	Form and Instruction	Modified	Person Organizational Quality Assessment_BSL
206576	Stress Resiliency Survey Battery	Form and Instruction	Modified	Perceived Stress Scale_BSL
206576	Stress Resiliency Survey Battery	Form and Instruction	Modified	Perceived Stress Scale_BS

ICR Details

OMB Control No: 1103-0113	ICR Reference No: 201309-1103-001
Status: Historical Active	Previous ICR Reference No: 201305-1103-003
Agency/Subagency: DOJ/DOJADM	Agency Tracking No:
Title: Milwaukee Police Department Stress Resiliency Questionnaires
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/01/2013
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/09/2013
Terms of Clearance: The results from this study should not be used to make general conclusions about the efficacy of the training program beyond the MPD.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2016	36 Months From Approved
Responses	60	0	0
Time Burden (Hours)	15	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Milwaukee Police Department (MPD) will be undertaking a battery of Stress Resiliency Questionnaires through a COPS cooperative agreement with the MPD. These surveys will be used to collect data on MPD officers' perceived stress, responses to stressful experiences, stress and its relationship to biometrics and related questionnaires.

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Authorizing Statute(s): PL: Pub.L. 103 - 322 Title I Name of Law: Violent Crime Control and Law Enforcement Act of 1994
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 1250	01/08/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 16536	03/15/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Stress Resiliency Survey Battery	N/A, N/A, N/A, N/A, N/A	Perceived Stress Scale_BS ,   Perceived Stress Scale_BSL ,   Person Organizational Quality Assessment_BSL ,   Vital Exhaustion BSL ,   Response to Stressful Experiences Scale BSL

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	60	0	0	60	0	0
Annual Time Burden (Hours)	15	0	0	15	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The Milwaukee Police Department Stress Resiliency Questionnaire ICR has an increase in burden hours due to it being a new collection instrument of the COPS Office.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/09/2013

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