Information Collection

Elder Justice Victim Needs Assessment (Individuals or households)

IC 260087 under ICR 202305-1105-004 · OMB 1105-0111.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
1105-0NEW Elder Justice Survey.docx	Other-Survey
1105-0NEW Elder Justice Survey.docx	Other-Survey

IC Title:

Agency IC Tracking Number:

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
Other-Survey					Yes	Yes	Fillable Printable

Line of Business: Law Enforcement

Subfunction: Citizen Protection

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	6,375	6,375

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.

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