Survey of Inmates in Local Jails Instrument Pretest

Generic Clearance for Cognitive, Pilot and Field Studies for Bureau of Justice Statistics Data Collection Activities

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0339 can be found here:

Documents and Forms

Document Name Document Type
Survey of Inmates in Local Jails Instrument Pretest Form and Instruction
SILJ Draft Instrument Appendix A - SILJ Pretest Instrument.docx Form and Instruction
OMB memo_SILJ Pretest.docx Memo to OMB for SILJ Pretest IC Document
Appendix B - SILJ Pretest Consent Form.docx Appendix B Consent Form IC Document
Appendix C - Recruitment Letter from Director of BJS.docx Appendix C Recruitment Letter IC Document
Appendix D - Non-interview Worksheet.docx Appendix D Noninterview Worksheet IC Document
Appendix E - SILJ Privacy Certificate.pdf Appendix E Privacy Certificate IC Document
Appendix F -Institutional_Review_Board_Notice_of_Approval_study_modification.pdf Appendix F IRB Approval IC Document

Information Collection (IC) Details

IC Title:	Survey of Inmates in Local Jails Instrument Pretest	Agency IC Tracking Number:	BJS

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	N/A	SILJ Draft Instrument	Appendix A - SILJ Pretest Instrument.docx		Yes	Yes	Fillable Fileable

Line of Business: Correctional Activities

Subfunction: Criminal Incarceration

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 370	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	370	370
Annual IC Time Burden (Hours)	587	587
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Memo to OMB for SILJ Pretest	OMB memo_SILJ Pretest.docx	03/05/2020
Appendix B Consent Form	Appendix B - SILJ Pretest Consent Form.docx	03/05/2020
Appendix C Recruitment Letter	Appendix C - Recruitment Letter from Director of BJS.docx	03/05/2020
Appendix D Noninterview Worksheet	Appendix D - Non-interview Worksheet.docx	03/05/2020
Appendix E Privacy Certificate	Appendix E - SILJ Privacy Certificate.pdf	03/05/2020
Appendix F IRB Approval	Appendix F -Institutional_Review_Board_Notice_of_Approval_study_modification.pdf	03/05/2020

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