Information Collection

Public Safety Officer Suicide Reporting Module

IC 251027 under ICR 202503-0920-009 · OMB 0920-0607.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0607 can be found here:

Documents and Forms

Document Name Document Type
Public Safety Officer Suicide Reporting Module Form and Instruction
Public Safety Officer Suicide Module ATT7~S8D.PDF Form and Instruction
Public Safety Officer Suicide Module ATT7~S8D.PDF Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Public Safety Officer Suicide Reporting Module	Agency IC Tracking Number:

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 and Instruction	n/a	Public Safety Officer Suicide Module	ATT7~S8D.PDF		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	24,024	24,024
Annual IC Time Burden (Hours)	4,004	4,004
Annual IC Cost Burden (Dollars)	82,883	82,883

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.