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Public Safety Officers' Appeal Request Application
Application for Public Safety Officers' Educational Assistance
OMB: 1121-0220
IC ID: 227413
OMB.report
DOJ/OJP
OMB 1121-0220
ICR 201707-1121-002
IC 227413
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0220 can be found here:
2024-01-31 - Revision of a currently approved collection
2020-10-30 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
request for appeal.xlsx
Other-questions
appeal with required docs.xlsx
Other-questions with requred documen
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Public Safety Officers' Appeal Request Application
Agency IC Tracking Number:
BJA
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-questions
request for appeal.xlsx
n/a
Yes
Yes
Fillable Fileable
Other-questions with requred documents
appeal with required docs.xlsx
n/a
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Litigation and Judicial Activities
Subfunction:
Legal Defense
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
75
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
75
0
75
0
0
0
Annual IC Time Burden (Hours)
38
0
38
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.