Information Collection

Public Safety Officers' Appeal Request Application

IC 227413 under ICR 202401-1121-004 · OMB 1121-0220.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
request for appeal.xlsx	Other-questions
request for appeal.xlsx	Other-questions
appeal with required docs.xlsx	Other-questions with requred documen
appeal with required docs.xlsx	Other-questions with requred documen

IC Title:

Agency IC Tracking Number:

BJA

Is this a Common Form? No

IC Status: Unchanged

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-questions			request for appeal.xlsx	n/a	Yes	Yes	Fillable Fileable
Other-questions with requred documents			appeal with required docs.xlsx	n/a	Yes	Yes	Fillable Fileable

Line of Business: Litigation and Judicial Activities

Subfunction: Legal Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 75

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	75	75
Annual IC Time Burden (Hours)	38	38
Annual IC Cost Burden (Dollars)	0	0

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.