83i

PAPERWORK REDUCTION ACT SUBMISSION
Please read the instructions

before completing this form. For additional forms or assistance

in completing this form, contact your agency's Paperwork

Clearance Officer. Send two copies of this form, the collection instrument to be reviewed, the Supporting Statement, and any additional documentation
to: Office of Information and Regulatory Affairs, Office of Management and Budget, Docket Library, Room 10102, 725 17th Street NW,
Washington, DC 20503.

1. Agency/Subagency

originating request

2. OMB control number

DOJ/FBIICJIS

1110
a. --_--

3. Type of information collection (check one)

b. 0

0071
- ----

--_-

4. Type of review requested (check one)

a. 0

New Collection

a.

b. 0

Revision of a currently approved collection

b. D

Emergency - Approval requested by: _/_/_

c . .;

Extension of a currently approved collection

c. D

Delegated

d.

without change, of a previously approved

Reinstatement,

Reinstatement,

[l] Regular

5. Small entities

collection for which approval has expired
e. 0

Will this information collection have a significant economic impact on a

with change, of a previously approved

substantial number of small entities?

collection for which approval has expired
f. 0

None

Yes

Existing collection in use without an OMB control number

[2J

No

6. Requested expiration date

For b-f, note Item A2 of Supporting Statement instructions

a.

illThree

years from the approval date

b.

I

--

I

L_

I

-_/_-

7. Title

National Use-of-Force Data Collection
B. Agency form number(s) (if applicable)

N/A - No form(s)
9. Keywords

Law Enforcement
10. Abstract

The National Use-of-Force Data Collection acquires and provides data on incidents where use of force by a law enforcement
officer led to a death or serious bodily injury or when an officer discharged a firearm at or in the direction of a person.
11. Affected public (Mark primary with "P" and al/ others with "X")
a. - Individuals or households
b. _ Business or other for-profit

d. - Farms
e. ~ Federal Government

c. _ Not-for-profit institutions

f.

13. Annual reporting and recordkeeping

.e. State,

12. Obligation to respond (Mark primary with "P" and all others that apply with "X")
b.

Local, or Tribal Government

hour burden

b. Total annual responses

Required to obtain or retain benefits

c. DMandatory

14. Annual reporting and recordkeeping cost burden(in thousands of dollars)

12861
94341

a. Number of respondents

IE]Voluntary

a.

a. Total annualized capital/startup

0
0
0
0
0

costs

b. Total annual costs (O&M)

1. Percentage of these responses

c. Total annualized cost requested

100

collected electronically

%

d. Current OMB inventory

59,749
37,554
22,195

c. Total annual hours requested
d. Current OMB inventory
e. Difference

e. Difference
f. Explanation of difference

1. Program change

f. Explanation of difference

0

2. Adjustment

1. Program change
2. Adjustment
+ Partici(2ation
15. Purpose of information collection (Mark primary with "Po and all others
that apply with "X")
a. _ Application for benefits

e. _ Program planning or management

b. _ Program evaluation

f.

c.

.E General

purpose statistics

2S. Research

g. _ Regulatory or compliance

d. - Audit

17. Statistical methods

c.

Recordkeeping

III Reporting:
1. .; On occasion
4.
7.

b.

0 Third

party disclosure

2.0

Weekly

Quarterly

5.

Semi-annually

Biennially

B.

Other (describe)

3. iZtv10nthly
6.
Annually

o

18. Agency contact (person who can best answer questions regarding the content

Does this information collection employ statistical methods?
Yes .;

OMB 83-1

16. Frequency of record keeping or reporting (check all that apply)
a. D

No

of this submission)
Name

Malissa C. Vavra

Phone:

(304) 625-3010
10/95

19. Certification for Paperwork Reduction Act Submissions
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with
5 CFR 1320.9.
NOTE: The text of 5 CFR 1320.9, and the related provisions of 5 CFR 1320.8(b)(3), appear at the end of the
instructions. The certification is to be made with reference to those regulatory provisions as set forth in
the instructions.

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) If 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 record keeping 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 (see note in Item 19 of the instructions);
(i) It uses effective and efficient statistical survey methodology (if applicable); and

0) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item below and explain the reason in
Item 18 of the Supporting Statement.

Signature of Senior Official or designee

OMB 83·1

Date

10/95