Information Collection Request

Law Enforcement Officers Killed or Assaulted (LEOKA)

ICR 202509-1110-001 · OMB 1110-0006 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1-705 Law Enforcement Officers Killed or Assaulted (LEOKA) Form and Instruction Modified Repair queued
Form 1-705 Law Enforcement Officers Killed or Assaulted (LEOKA) Form and Instruction Modified Available
Privacy Act Statement - LEOKA 1-705 (1110-0006).docx Supplementary Document Uploaded 2025-09-19 Repair queued
Privacy Act Statement - LEOKA 1-705 (1110-0006).docx Supplementary Document Uploaded 2025-09-19 Available
ICR-PA (1110-0006).pdf Supplementary Document Uploaded 2025-09-19 Repair queued
ICR-PA (1110-0006).pdf Supplementary Document Uploaded 2025-09-19 Available
Cert. Stmnt. (1110-0006).pdf Supplementary Document Uploaded 2025-09-19 Repair queued
Cert. Stmnt. (1110-0006).pdf Supplementary Document Uploaded 2025-09-19 Available
83-I (1110-0006).pdf Supplementary Document Uploaded 2025-09-19 Repair queued
83-I (1110-0006).pdf Supplementary Document Uploaded 2025-09-19 Available
Supporting Statement B (1110-0006).docx Supporting Statement B Uploaded 2025-09-19 Repair queued
Supporting Statement B (1110-0006).docx Supporting Statement B Uploaded 2025-09-19 Available
Supporting Statement A (1110-0006)_8.5.26 FINAL.docx Supporting Statement A Uploaded 2026-08-05 Repair queued
Supporting Statement A (1110-0006).docx Supporting Statement A Uploaded 2025-09-22 Available
1110-0006 Privacy Assessment.pdf Supplementary Document Uploaded 2022-09-23 Repair queued
1110-0006 Privacy Assessment.pdf Supplementary Document Uploaded 2022-09-23 Available
28usc534.doc Supplementary Document Uploaded 2019-07-29 Repair queued
28usc534.doc Supplementary Document Uploaded 2019-07-29 Available
Certification Statement.pdf Supplementary Document Uploaded 2019-07-29 Repair queued
Certification Statement.pdf Supplementary Document Uploaded 2019-07-29 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
11799 Law Enforcement Officers Killed or Assaulted (LEOKA) Form and Instruction ModifiedLaw Enforcement Officers Killed or Assaulted (LEOKA)
11799 Law Enforcement Officers Killed or Assaulted (LEOKA) Form and Instruction ModifiedLaw Enforcement Officers Killed or Assaulted (LEOKA)

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2029 36 Months From Approved 08/31/2026
13,008 0 64,734
1,518 0 7,552
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Law Enforcement Officers Killed or Assaulted (LEOKA) 1-705

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 13,008 64,734 0 -51,726 0 0
Annual Time Burden (Hours) 1,518 7,552 0 -6,034 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No