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Federal forms, ICRs, and supporting documents

Information Collection Request

Report of Public Safety Officers Permanent and Total Disability

ICR 199805-1121-001 · OMB 1121-0166 · Historical Inactive

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
12431 Report of Public Safety Officers Permanent and Total Disability Form Migrated
ICR Details
1121-0166 199805-1121-001
Historical Inactive 199107-1121-002
DOJ/OJP
Report of Public Safety Officers Permanent and Total Disability
Reinstatement with change of a previously approved collection   No
Regular
Withdrawn 05/19/1998
Retrieve Notice of Action (NOA) 05/07/1998
  Inventory as of this Action Requested Previously Approved
0 0 0
0 0 0
0 0 0
The Public Safety Officers' disability program provides a benefit to Public Safety Officers who have become permanently and totally disabled by a catastrophic injury sustained in the line of duty.
None
None
No
1
IC Title Form No. Form Name
Report of Public Safety Officers Permanent and Total Disability OJP-3650/7
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (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;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
05/07/1998