Information Collection

Mortality in Correctional Institutions

IC 234820 under ICR 201901-1121-001 · OMB 1121-0249.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0249 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NPS-4 Mortality in Correctional Institutions	Form and Instruction
CJ-9 MCI Death Reports on Inmates under Jail Jurisdiction CJ9_2018.pdf	Form and Instruction
CJ-9A MCI Annual Summary on Inmates Under Jail Jurisdiction CJ9A_2018.pdf	Form and Instruction
CJ-10 MCI Death Report on Inmates in Private & Multi-Jurisdict CJ10_2018.pdf	Form and Instruction
CJ-10A MCI Annual Summary on Inmates in Private & Multi-Jurisdi CJ10A_2018.pdf	Form and Instruction
NPS-4 MCI Annual Summary of Inmate Deaths in State Prisons NPS4_2018.pdf	Form and Instruction
NPS-4A MCI State Prison Inmate Death Report NPS4A_2018.pdf	Form and Instruction
appendices.pdf MCI Appendices	IC Document

IC Title:

Mortality in Correctional Institutions

Agency IC Tracking Number:

BJS

Is this a Common Form? No

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NPS-4	MCI Annual Summary of Inmate Deaths in State Prisons	NPS4_2018.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	NPS-4A	MCI State Prison Inmate Death Report	NPS4A_2018.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	CJ-9	MCI Death Reports on Inmates under Jail Jurisdiction	CJ9_2018.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	CJ-9A	MCI Annual Summary on Inmates Under Jail Jurisdiction	CJ9A_2018.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	CJ-10	MCI Death Report on Inmates in Private & Multi-Jurisdictional Jails	CJ10_2018.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	CJ-10A	MCI Annual Summary on Inmates in Private & Multi-Jurisdictional Jails	CJ10A_2018.pdf	Yes	Yes	Fillable Fileable

Line of Business: Correctional Activities

Subfunction: Criminal Incarceration

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,050

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,050	3,050
Annual IC Time Burden (Hours)	3,823	3,823
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
MCI Appendices	appendices.pdf	02/04/2019

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