Information Collection

Census of Adult Supervising Agencies (CAPSA) Pilot Test

IC 207060 under ICR 201503-1121-001 · OMB 1121-0339.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0339 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CAPSA 2013 Public Census of Adult Supervising Agencies (CAPSA) Pilot Test	Form and Instruction
CAPSA 2013 Public CAPSA Questionnaire - Public Attachment A_CAPSA Questionnaire - Public 05-06-13.pdf	Form and Instruction
CAPSA 2013 Private CAPSA Questionaire -- Private Attachment B CAPSA Questionnaire - Private_revised 6-24-13.pdf	Form and Instruction
Attachment C_all other CAPSA materials_05-10-13.pdf Attachments to CAPSA Pilot Test	IC Document
OMB Memo CAPSA Pilot Test_revised 6-24-13.docx CAPSA Pilot Memo	IC Document

IC Title:

Census of Adult Supervising Agencies (CAPSA) Pilot Test

Agency IC Tracking Number:

BJS

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CAPSA 2013 Public	CAPSA Questionnaire - Public	Attachment A_CAPSA Questionnaire - Public 05-06-13.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	CAPSA 2013 Private	CAPSA Questionaire -- Private	Attachment B CAPSA Questionnaire - Private_revised 6-24-13.pdf		No		Paper Only

Line of Business: Correctional Activities

Subfunction: Criminal Rehabilitation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 60

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachments to CAPSA Pilot Test	Attachment C_all other CAPSA materials_05-10-13.pdf	05/23/2013
CAPSA Pilot Memo	OMB Memo CAPSA Pilot Test_revised 6-24-13.docx	06/24/2013

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