Application for Public Safety Officers' Educational Assistance

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Supporting Statement 2 - PSOB Program.docx	Supporting Statement A	Uploaded 2024-01-31	Repair queued
PSOB_LEGISLATION.pdf	Supplementary Document	Uploaded 2013-07-26	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
227413	Public Safety Officers' Appeal Request Application	Other-questions	Unchanged
227412	Public Safety Officers' Disability Beneftis Application	Other-questions	Unchanged
227411	Public Safety Officers' Death Benefits Application	Other-questions	Unchanged
12501	Application for Public Safety Officers' Educational Assistance	Other-questions	Modified

ICR Details

OMB Control No: 1121-0220	ICR Reference No: 202401-1121-004
Status: Active	Previous ICR Reference No: 202010-1121-003
Agency/Subagency: DOJ/OJP	Agency Tracking No: BJA
Title: Application for Public Safety Officers' Educational Assistance
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/11/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/31/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2027	36 Months From Approved	04/30/2024
Responses	825	0	725
Time Burden (Hours)	2,788	0	2,738
Cost Burden (Dollars)	0	0	0

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Abstract: The agency requires the information requested on this application to determine if individuals are eligible to receive educational assistance through the Public Safety Officers' Educational Assistance (PSOEA) Program, as established by the PSOEA Act of 1998 (P.L. 104-238). Respondents who complete the application may be spouses or eligible children of public safety officers who were killed or permanently and totally disabled in the line of duty.

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Authorizing Statute(s): PL: Pub.L. 104 - 238 1211 Name of Law: Public Safety Officer's Benefits
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 88113	12/20/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 88114	01/31/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Application for Public Safety Officers' Educational Assistance
Public Safety Officers' Appeal Request Application
Public Safety Officers' Death Benefits Application
Public Safety Officers' Disability Beneftis Application

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	825	725	0	100	0	0
Annual Time Burden (Hours)	2,788	2,738	0	50	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Increase in respondents

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Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/31/2024

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