Information Collection

Identity Theft Supplement to the NCVS

IC 217871 under ICR 202104-1121-003 · OMB 1121-0317.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Identity Theft Supplement to the NCVS	Form and Instruction
Identity Theft Supplement Questionnaire A1.its14.pdf	Form and Instruction
Identity Theft Supplement Questionnaire A1.its14.pdf	Form and Instruction
Attachments.pdf ITS Supplementary Materials	IC Document
Attachments.pdf ITS Supplementary Materials	IC Document

IC Title:

Agency IC Tracking Number:

BJS

Is this a Common Form? No

IC Status: Removed

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	Identity Theft Supplement Questionnaire	A1.its14.pdf		Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 113,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-113,000	113,000
Annual IC Time Burden (Hours)	-10,227	10,227
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
ITS Supplementary Materials	Attachments.pdf	08/12/2015

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