OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Public Safety Officers' Educational Assistance

ICR 201701-1121-001 · OMB 1121-0220 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form OJP form 1240 Application for Public Safety Officers' Educational Assistance Form and Instruction Unchanged Repair queued
PSOEA_JUSTIFICATION_20101.doc Supporting Statement A Uploaded 2014-01-02 Repair queued
PSOB_LEGISLATION.pdf Supplementary Document Uploaded 2013-07-26 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
12501 Application for Public Safety Officers' Educational Assistance Form and Instruction Unchanged
ICR Details
1121-0220 201701-1121-001
Historical Active 201307-1121-001
DOJ/OJP BJA
Application for Public Safety Officers' Educational Assistance
Extension without change of a currently approved collection   No
Regular
Approved without change 03/10/2017
Retrieve Notice of Action (NOA) 01/31/2017
  Inventory as of this Action Requested Previously Approved
03/31/2020 36 Months From Approved 03/31/2017
150 0 150
50 0 50
0 0 0
The agency requires the information requested on this application to determine if individuals are eligible to receive educational assistance through the Public Safety Officers' Educational Assistance (PSOEA) Program, as established by the PSOEA Act of 1998 (P.L. 104-238). Respondents who complete the application may be spouses or eligible children of public safety officers who were killed or permanently and totally disabled in the line of duty.
PL: Pub.L. 104 - 238 1211 Name of Law: Public Safety Officer's Benefits
  
None
Not associated with rulemaking
  81 FR 84617 11/23/2016
82 FR 8762 01/30/2017
No
1
IC Title Form No. Form Name
Application for Public Safety Officers' Educational Assistance OJP form 1240 PSOBEA
  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 150 150 0 0 0 0
Annual Time Burden (Hours) 50 50 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$3,179
No
Yes
No
No
No
Uncollected
Angela Scarborough 202 305-2026 [email protected]
  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.
01/31/2017