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Survey of Inmates in Local Jails Instrument Pretest
Generic Clearance for Cognitive, Pilot and Field Studies for Bureau of Justice Statistics Data Collection Activities
OMB: 1121-0339
IC ID: 240420
OMB.report
DOJ/OJP
OMB 1121-0339
ICR 201902-1121-003
IC 240420
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0339 can be found here:
2022-02-23 - Revision of a currently approved collection
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
View Information Collection (IC)
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
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:
370
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
90 %
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
370
0
370
0
0
0
Annual IC Time Burden (Hours)
587
0
587
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.