Information Collection

Application for Public Safety Officers' Educational Assistance

IC 12501 under ICR 201707-1121-002 · OMB 1121-0220.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0220 can be found here:

Documents and Forms

Document Name Document Type
Education.xlsx Other-questions
education with required docs.xlsx Other-questions

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Public Safety Officers' Educational Assistance	Agency IC Tracking Number:	BJA

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-questions			Education.xlsx	n/a	Yes	Yes	Fillable Fileable
Other-questions			education with required docs.xlsx	n/a	Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	200	50	150
Annual IC Time Burden (Hours)	100	50	50
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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