State Corrections Incident Report for Prison Input

Death in Custody Reporting Act

Documents and Forms

Document Name Document Type
State Corrections Incident Report for Prison Input Form
State Corrections Incident Report for Prison Input DCR-1A Death Report.pdf Form

Information Collection (IC) Details

IC Title:	State Corrections Incident Report for Prison 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 for Prison Input	DCR-1A Death Report.pdf	TBD	Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Leadership Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	3,483	3,483
Annual IC Time Burden (Hours)	2,612	2,612
Annual IC Cost Burden (Dollars)	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.