LAW ENFORCEMENT OFFICERS CONGRESSIONAL BADGE OF BRAVERY

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
witness page	Form	New	Available
thanks page	Form	New	Available
supporting form page	Form	New	Available
nominee form page	Form	New	Available
nominator form page	Form	New	Available
event form page	Form	New	Available
completion page	Form	New	Available
Congressional Badge of Bravery application	Form	New	Available
Congressional Badge of Bravery screen shots page 8	Form	Removed	Available
Congressional Badge of Bravery screen shots page 7	Form	Removed	Available
Congressional Badge of Bravery screen shots 6	Form	Removed	Available
Congressional Badge of Bravery screen shots	Form	Removed	Available
Congressional Badge of Bravery screen shots page 4	Form	Removed	Available
Congressional Badge of Bravery screen shots page 3	Form	Removed	Available
Congressional Badge of Bravery screen shots page 2	Form	Removed	Available
Congressional Badge of Bravery screen shots page 1	Form	Removed	Available
CBOB_JUSTIFICATION_2013.doc	Supporting Statement A	Uploaded 2013-10-30	Available
CONGRESSIONAL BADGE LEGISLATION.pdf	Supplementary Document	Uploaded 2010-07-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
209119	Congressional Badge of Bravery	Form	New	witness page
209119	Congressional Badge of Bravery	Form	New	thanks page
209119	Congressional Badge of Bravery	Form	New	supporting form page
209119	Congressional Badge of Bravery	Form	New	nominee form page
209119	Congressional Badge of Bravery	Form	New	nominator form page
209119	Congressional Badge of Bravery	Form	New	event form page
209119	Congressional Badge of Bravery	Form	New	completion page
209119	Congressional Badge of Bravery	Form	New	Congressional Badge of Bravery application
193778	Law Enforcement Officers Congressional Badge of Bravery	Form	Removed	Congressional Badge of Bravery screen shots page 8
193778	Law Enforcement Officers Congressional Badge of Bravery	Form	Removed	Congressional Badge of Bravery screen shots page 7
193778	Law Enforcement Officers Congressional Badge of Bravery	Form	Removed	Congressional Badge of Bravery screen shots 6
193778	Law Enforcement Officers Congressional Badge of Bravery	Form	Removed	Congressional Badge of Bravery screen shots
193778	Law Enforcement Officers Congressional Badge of Bravery	Form	Removed	Congressional Badge of Bravery screen shots page 4
193778	Law Enforcement Officers Congressional Badge of Bravery	Form	Removed	Congressional Badge of Bravery screen shots page 3
193778	Law Enforcement Officers Congressional Badge of Bravery	Form	Removed	Congressional Badge of Bravery screen shots page 2
193778	Law Enforcement Officers Congressional Badge of Bravery	Form	Removed	Congressional Badge of Bravery screen shots page 1

ICR Details

OMB Control No: 1121-0330	ICR Reference No: 201310-1121-002
Status: Historical Active	Previous ICR Reference No: 201003-1121-001
Agency/Subagency: DOJ/OJP	Agency Tracking No: BJA
Title: LAW ENFORCEMENT OFFICERS CONGRESSIONAL BADGE OF BRAVERY
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/02/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/30/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2017	36 Months From Approved
Responses	184	0	0
Time Burden (Hours)	61	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Under Public Law No: 110-298 The US Department of Justice Attorney General may request voluntary nominations from an appointed Federal Board, for the names of law enforcement officers cited as performing an act of bravery while in the line of duty, for a Federal Law Enforcement Congressional Badge of Bravery award.

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Authorizing Statute(s): PL: Pub.L. 110 - 298 2565 Name of Law: Federal Law Enforcement Officers Congressional Badge of Bravery Act
  

Citations for New Statutory Requirements: PL: Pub.L. 110 - 298 Title1 Sec 102 (b)(3) Name of Law: Law Enforcement COngressional Badge of Bravery

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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 45971	07/30/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 61868	10/04/2013
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
Congressional Badge of Bravery	none, none, none, none, none, none, none, none	Congressional Badge of Bravery application ,   completion page ,   event form page ,   nominator form page ,   nominee form page ,   supporting form page ,   thanks page ,   witness page
Law Enforcement Officers Congressional Badge of Bravery	none, none, none, none, none, none, none, None	Congressional Badge of Bravery screen shots page 1 ,   Congressional Badge of Bravery screen shots page 2 ,   Congressional Badge of Bravery screen shots page 3 ,   Congressional Badge of Bravery screen shots page 4 ,   Congressional Badge of Bravery screen shots ,   Congressional Badge of Bravery screen shots 6 ,   Congressional Badge of Bravery screen shots page 7 ,   Congressional Badge of Bravery screen shots page 8

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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	184	0	0	0	-16	200
Annual Time Burden (Hours)	61	0	0	0	-22	83
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 previously approved collection expired and this collection is being reinstated. The only adjustment to this collection is the number of respondents.

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Annual Cost to Federal Government: $4,370

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: 10/30/2013

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