83-i

PAPERWORK REDUCTION ACT SUBM ISSION
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, 72517th Street NW,
Washington, DC 20503.
1. Agency/Subagency

originating

request

2. OMB control

DOJIFBIICJIS
3. Type of information

collectton

a!:;

New collection

bbJ
c.1T

Revision

(check

without

approved

change,

Reinstatement.
which approval

eC

Reinstatement,
with change,
approval has expired

f·b

Existing collection

3a. Public

b.
approved

without change, of a previously
has expired
of a previously

in use without

----

4. Type of review requested

collection

of a currently

de

collection

approved

c.

collection

an OMS control

Yes

None

----

(check

one)

Regular

g_ Emergency
!d Delegated

- Approval

requested

by: __

1
__

1_-

for

collection

for which

number

Will this information col/ection have a significant
substantial number of small entities?
Yes

6. Requ ested expiration
public comments

C

5. Small entities

approved

C omm ents

Has the agency received

b.

_ 0001

----

a.~

of a currently

Extension,

one)

number

1110

a.

on this information

collection?

a. ~

Three

economic

impact

-

~

b.DOther

Specify: ___

on a

No

date

years from approval

date

I___

'" No

7. Title

Return A-Monthly Return of Offenses Known to Police and Supplement to Return A-Monthly Return of Offenses Known to Police
8. Agency form num ber{s)

(if applicable)

1-720 and 1-706
9. Keywords

Criminal Offenses, Clearances, Return A
10. Abstract

Under 34 USC 41303 and 28 USC 534, this collection requests offense data from federal, state, county, city,
tribal, and territorial law enforcement agencies in order for the FBI's UCR Program to serve as the national
clearinghouse for the collection and dissemination of crime data.
11. Affected

public (Mark primary

- Business
b
a

Individuals

d
e. x

Not-far-profit

institutions

13. Annual reporting

hnur

1.Percentage
collected

Government

hump.n

60.447

1 Program

4.657

15. Purpose of information collection
others that apply with ·X·)
b. _Program
c. ~General
d. _Audit

17. Statistical

for benefits
evaluation
purpose

statistics

Transnion

- Agency

(Mark primary

with ·P" and a/l

collection

employ

statistical

-=- Yes

-

or management

or compliance

methods

Does this information

0
·0

of difference
0

change

-

methods?
No

16. Frequency of recordkeeping
a. _Recordkeeping
c. "::'_Reporting
1.
On occasion

0

18. Agency
submission)
Name:

or reporting

5. _Semi-annually

8. ~Other

contact

(person

Malissa

C.

(check

all that apply)

b. _ Third party disclosure

2. _Weekly

4. _Quarterly
7. _Biennially

Phone:

OMB 83-1

0

Decrease

e. _Program
planning
f. _.:_Research
g. _Regulatory

of dollars)

0
0

cost requested

2. Adjustment
NIBRS

that apply with "X")

cost burden fin thousands

costs

OMB inventory

f. Explanation

15,235

e. Difference

a. _Application

and recordkeeping

e. Difference

f. Explanation of differenr:p.
1. Program change ____
2. Adjustment

reporting

d. Current
10,578

d. Current 0 MB inventory

with "P" and all others

Required to obtain or retain benefits
Mandatory

c. Total annuaized

100

c. Total annual hours requested

-

X

a. Total annualized capitallstartup
b. Total annual costs (O&M)

of these respnn~p.~

electronically

c.

to respond (Mark primary

Voluntary

14. Annual

2.381

a. Number of respondents
b. Total annual responses

12. Obligation
a. ~
b.

Govemment

State. Local or Tribal

f.~

and recordkeepin9

that apply with "X")

Farms

- Federal

or other for-profit

-

c._

with "P" and all others

or households

(describe)

3. "::'Monthly
6.
Annuallv
Vanably

who can best answer

questions

regarding

the content

of this

Vavra

771-228·2268

02/04

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)

It avoids unnecessary duplication;

(c)

It reduces burden on small entities;

(d)

It uses plain, coherent, and unambiguous terminology that is understandable to respondents;

(e)

Its implementation

(f)

It indicates the retention period for record keeping requirements;

(g)

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

will be consistent and compatible with current reporting and recordkeeping practices;

(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; and

U)

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

02/04