Crime Victims' Rights Act Complaint Form

Crime Victims’ Rights Act Complaint Form

Documents and Forms

Document Name Document Type
Crime Victims' Rights Act Complaint Form Form
CVRA Complaint Form Collection Instrument - English (CVRA Complaint Form) (002).pdf www.justice.gov/usao/office-victims-rights-ombuds Form
CVRA Complaint Form Collection Instrument - English (CVRA Complaint Form) (002).pdf www.justice.gov/usao/office-victims-rights-ombuds Form
CVRA Complaint Form Collection Instrument - Spanish (CVRA Complaint Form).pdf www.justice.gov/usao/office-victims-rights-ombuds Form
CVRA Complaint Form Collection Instrument - Spanish (CVRA Complaint Form).pdf www.justice.gov/usao/office-victims-rights-ombuds Form
Screenshot of Collection Instrument Website.pdf Web-portal screenshot IC Document
Screenshot of Collection Instrument Website.pdf Web-portal screenshot IC Document

Information Collection (IC) Details

IC Title:	Crime Victims' Rights Act Complaint Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	CVRA Complaint Form	Collection Instrument - English (CVRA Complaint Form) (002).pdf	https://www.justice.gov/usao/office-victims-rights-ombuds	Yes	Yes	Fillable Fileable
Form	None	CVRA Complaint Form	Collection Instrument - Spanish (CVRA Complaint Form).pdf	https://www.justice.gov/usao/office-victims-rights-ombuds	Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Citizen Protection

Privacy Act System of Records
Title: Civil Case Files	FR Citation: 82 FR 24147

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	75	75
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Web-portal screenshot	Screenshot of Collection Instrument Website.pdf	07/11/2023

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