Information Collection

Mortality in Correctional Institutions

IC 234820 under ICR 202105-1121-001 · OMB 1121-0249.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CJ-9 Mortality in Correctional Institutions	Form and Instruction
CJ-9 MCI Death Reports on Inmates under Jail Jurisdiction CJ9_2018.pdf	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-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-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
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-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
NPS-4A MCI State Prison Inmate Death Report NPS4A_2018.pdf	Form and Instruction
appendices.pdf MCI Appendices	IC Document
appendices.pdf MCI Appendices	IC Document

IC Title:

Agency IC Tracking Number:

BJS

Is this a Common Form? No

IC Status: Unchanged

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	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
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

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	Previously Approved
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.