Survey on Sexual Victimization

Survey of Sexual Victimization, 2016-2018

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0292 can be found here:

Documents and Forms

Document Name Document Type
Form SSV-1 Survey on Sexual Victimization Form and Instruction
SSV-1 SSV Federal Bureau of Prisons Summary Form SSV-1.pdf Form and Instruction
SSV-2 SSV State Prison Systems Summary Form SSV-2.pdf Form and Instruction
SSV-3 SSV Local Jail Jurisdictions Summary Form SSV-3.pdf Form and Instruction
SSV-4 SSV Other Correctional Facilities Summary Form SSV-4.pdf Form and Instruction
SSV-5 SSV State Juvenile Systems Summary Form SSV-5.pdf Form and Instruction
SSV-6 SSV Locally or Privately-Operated Juvenile Facilities Su SSV-6.pdf Form and Instruction
SSV IA SSV Incident Form Adult SSV-IA.pdf Form and Instruction
SSV IJ SSV Incident Form Juveniles SSV-IJ.pdf Form and Instruction
Attachments.pdf SSV Attachments with Table of Contents IC Document

Information Collection (IC) Details

IC Title:	Survey on Sexual Victimization	Agency IC Tracking Number:	BJS

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSV-1	SSV Federal Bureau of Prisons Summary Form	SSV-1.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	SSV-2	SSV State Prison Systems Summary Form	SSV-2.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	SSV-3	SSV Local Jail Jurisdictions Summary Form	SSV-3.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	SSV-4	SSV Other Correctional Facilities Summary Form	SSV-4.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	SSV-5	SSV State Juvenile Systems Summary Form	SSV-5.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	SSV-6	SSV Locally or Privately-Operated Juvenile Facilities Summary Form	SSV-6.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	SSV IA	SSV Incident Form Adult	SSV-IA.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	SSV IJ	SSV Incident Form Juveniles	SSV-IJ.pdf	Yes	Yes	Fillable Fileable

Line of Business: Correctional Activities

Subfunction: Criminal Incarceration

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,538	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 45 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-1,538	1,538
Annual IC Time Burden (Hours)	-1,353	1,353
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSV Attachments with Table of Contents	Attachments.pdf	03/14/2014

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