OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Public Safety Officers' Educational Assistance

ICR 201707-1121-002 · OMB 1121-0220 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
2017-18288.pdf Supplementary Document Uploaded 2017-09-26 Available
2017-12778.pdf Supplementary Document Uploaded 2017-09-26 Repair queued
Supporting Statement 2 - PSOB Program.doc Supporting Statement A Uploaded 2017-09-26 Repair queued
PSOB_LEGISLATION.pdf Supplementary Document Uploaded 2013-07-26 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
227413 Public Safety Officers' Appeal Request Application Other-questions New
227412 Public Safety Officers' Disability Beneftis Application Other-questions New
227411 Public Safety Officers' Death Benefits Application Other-questions New
12501 Application for Public Safety Officers' Educational Assistance Other-questions Modified
ICR Details
1121-0220 201707-1121-002
Historical Active 201701-1121-001
DOJ/OJP BJA
Application for Public Safety Officers' Educational Assistance
Revision of a currently approved collection   No
Regular
Approved without change 10/02/2017
Retrieve Notice of Action (NOA) 08/30/2017
  Inventory as of this Action Requested Previously Approved
10/31/2020 36 Months From Approved 03/31/2020
725 0 150
2,738 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
  82 FR 28094 06/20/2017
82 FR 41056 08/29/2017
No
  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 725 150 0 575 0 0
Annual Time Burden (Hours) 2,738 50 0 2,688 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Changing Regulations
No
The increase in burden is due to the changing forms for this collection. We have combined forms and added one form.
No
    No
    No
No
No
No
Uncollected
Michelle Martin 202 514-9354
  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.
08/30/2017