Information Collection

National Survey of Victim Service Providers Field Test of Questionnaire

IC 217097 under ICR 201503-1121-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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
National Survey of Victim Service Providers Field Test of Questionnaire	Form and Instruction
NSVSP NSVSP Questionnaire.pdf	Form and Instruction
NSVSP OMB Generic Clearance Memo - FieldTesting.docx Memo to OMB re: NCVP Field Test of Questionnaire	IC Document
NEW Supplemental NSVSP Materials for OMB Submission 061715.pdf NSVP Instrument and supporting documents	IC Document

IC Title:

National Survey of Victim Service Providers Field Test of Questionnaire

Agency IC Tracking Number:

BJS

IC Status: New

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	N/A	NSVSP	NSVSP Questionnaire.pdf		Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Citizen Protection

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 725

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	725	725
Annual IC Time Burden (Hours)	305	305
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Memo to OMB re: NCVP Field Test of Questionnaire	NSVSP OMB Generic Clearance Memo - FieldTesting.docx	06/18/2015
NSVP Instrument and supporting documents	NEW Supplemental NSVSP Materials for OMB Submission 061715.pdf	06/18/2015

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