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State Corrections Incident Report Jail Input
Death in Custody Reporting Act
OMB: 1121-0365
IC ID: 233650
OMB.report
DOJ/OJP
OMB 1121-0365
ICR 202108-1121-004
IC 233650
( )
Documents and Forms
Document Name
Document Type
State Corrections Incident Report Jail Input
Form
State Corrections Incident Report Jail Input
DCR-1A Death Report.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
State Corrections Incident Report Jail Input
Agency IC Tracking Number:
BJA
Is this a Common Form?
No
IC Status:
Unchanged
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
none
State Corrections Incident Report Jail Input
DCR-1A Death Report.pdf
TBD
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Law Enforcement
Subfunction:
Leadership Protection
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
600
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
1,056
0
0
0
1,056
0
Annual IC Time Burden (Hours)
792
0
0
0
792
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.
