Law Enforcement Officer Survey

Surveillance of Nonfatal Injuries Among On-Duty Law Enforcement Officers

Documents and Forms

Document Name Document Type
Form 0920-18APJ Law Enforcement Officer Survey Form and Instruction
0920-18APJ Law Enforcement Officer Survey Attachment C _survey clean.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Law Enforcement Officer Survey	Agency IC Tracking Number:	0920-18APJ

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
Form and Instruction	0920-18APJ	Law Enforcement Officer Survey	Attachment C _survey clean.docx	na	No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	4,650	4,650

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.