Information Collection

NCVS Companion Survey (CS)

IC 201425 under ICR 201203-1121-001 · OMB 1121-0325.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0325 can be found here:

Documents and Forms

Document Name Document Type
NCVS Companion Survey (CS) Form
Survey of Neighborhood Safety Attachment E - Approach 2B Mail Screener.pdf Form
Survey of Chicagoland Neighorhoods Attachment F1 - Approach 2C Mail Screener (local version).pdf Form
Survey of Neighborhoods Attachment F2 - Approach 2C Mail Screener (generic version).pdf Form
Appendix Bundle.docx Appendix Bundle IC Document
NCVS CS OMB Pilot Summary.docx NCVS CS OMB Pilot Summary IC Document
Attachment G - NCVS1 Core - Basic Screen Questionnaire.pdf NCVS1 Core - Basic Screen Questionnaire IC Document
Attachment H - NCVS2 Core - Crime Incident Report (2).pdf NCVS2 Core - Crime Incident Report IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NCVS Companion Survey (CS)	Agency IC Tracking Number:	BJS

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	None	Survey of Neighborhood Safety	Attachment E - Approach 2B Mail Screener.pdf	No	Paper Only
Form	None	Survey of Chicagoland Neighorhoods	Attachment F1 - Approach 2C Mail Screener (local version).pdf	No	Paper Only
Form	None	Survey of Neighborhoods	Attachment F2 - Approach 2C Mail Screener (generic version).pdf	No	Paper Only

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14,549	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	14,549	14,549
Annual IC Time Burden (Hours)	4,228	4,228
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix Bundle	Appendix Bundle.docx	03/06/2012
NCVS CS OMB Pilot Summary	NCVS CS OMB Pilot Summary.docx	03/06/2012
NCVS1 Core - Basic Screen Questionnaire	Attachment G - NCVS1 Core - Basic Screen Questionnaire.pdf	03/06/2012
NCVS2 Core - Crime Incident Report	Attachment H - NCVS2 Core - Crime Incident Report (2).pdf	03/06/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.