OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

National Inmate Survey Prisons (NIS-4) Pilot Test

IC 237777 under ICR 201902-1121-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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 Inmate Survey Prisons (NIS-4) Pilot Test	Form and Instruction
NIS-4 Questionnaire Specifications for Combined Instrume Year 4 NIS Specification_9-1-19.doc	Form and Instruction
NIS-4 OMB Memo Pilot_FINAL.docx NIS-4 Pilot Test Memo to OMB	IC Document
NIS-4 OMB Memo Pilot_Attachments.pdf NIS-4 Pilot Test Attachments	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

National Inmate Survey Prisons (NIS-4) Pilot Test

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	NIS-4 Questionnaire Specifications for Combined Instrument	Year 4 NIS Specification_9-1-19.doc		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Correctional Activities

Subfunction: Criminal Incarceration

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 78

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 85 %

table that charts list of burden
	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	78	0	78	0	0	0
Annual IC Time Burden (Hours)	65	0	65	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NIS-4 Pilot Test Memo to OMB	NIS-4 OMB Memo Pilot_FINAL.docx	09/18/2019
NIS-4 Pilot Test Attachments	NIS-4 OMB Memo Pilot_Attachments.pdf	09/18/2019

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