Information Collection

Law Enforcement Suicide Data Collection

IC 250573 under ICR 202108-1110-003 · OMB 1110-0082.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1110-0082 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Unnumbered Law Enforcement Suicide Data Collection	Form and Instruction
Unnumbered Law Enforcement Suicide Data Collection LESDC Pilot Questionnaire OPM - Copy.docx	Form and Instruction
Unnumbered Law Enforcement Suicide Data Collection LESDC Pilot Questionnaire OPM - Copy.docx	Form and Instruction

IC Title:

Law Enforcement Suicide Data Collection

Agency IC Tracking Number:

Is this a Common Form? No

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	Unnumbered	Law Enforcement Suicide Data Collection	LESDC Pilot Questionnaire OPM - Copy.docx		Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Citizen Protection

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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