Information Collection

National Crime Victimization Survey, 2018-2021

IC 230748 under ICR 202109-1121-002 · OMB 1121-0111.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0111 can be found here:

Documents and Forms

Document Name Document Type
Form NCVS-1 National Crime Victimization Survey, 2018-2021 Form
NCVS-1 Basic Screener Questionnaire Attachment 2. NCVS-1 (Basic Screen Questionnaire)_revised.pdf Form
NCVS-1 Basic Screener Questionnaire Attachment 2. NCVS-1 (Basic Screen Questionnaire)_revised.pdf Form
NCVS-2 Crime Incident Report NCVS-2 (Crime Incident Report)_no expiration date.pdf Form and Instruction
NCVS-2 Crime Incident Report NCVS-2 (Crime Incident Report)_no expiration date.pdf Form and Instruction
NCVS-500 Control Card NCVS-500 (Control Card).pdf Form and Instruction
NCVS-500 Control Card NCVS-500 (Control Card).pdf Form and Instruction
NCVS OMB Supporting Statement Attachments.pdf NCVS Attachments IC Document
NCVS OMB Supporting Statement Attachments.pdf NCVS Attachments IC Document
NCVS-572(L)_All Languages_no expiration date.pdf Letter to participants no expiration date IC Document
NCVS-572(L)_All Languages_no expiration date.pdf Letter to participants no expiration date IC Document
NCVS-573(L)_All Languages_no expiration date.pdf Follow up letter to participants no expiration date IC Document
NCVS-573(L)_All Languages_no expiration date.pdf Follow up letter to participants no expiration date IC Document
NCVS Screenshot with OMB number_201803 instrument_no expiration date.pdf Screen shot with no expiration date IC Document
NCVS Screenshot with OMB number_201803 instrument_no expiration date.pdf Screen shot with no expiration date IC Document
Attachment 3. NCVS-521 (CAPI Self-Study)_revised.pdf Final CAPI Self-Study NCVS-521 IC Document
Attachment 3. NCVS-521 (CAPI Self-Study)_revised.pdf Final CAPI Self-Study NCVS-521 IC Document
Attachment 4. NCVS-522(I) (Initial Training Guide)_revised.pdf Initial Training Guide - Final IC Document
Attachment 4. NCVS-522(I) (Initial Training Guide)_revised.pdf Initial Training Guide - Final IC Document
Attachment 5. NCVS-550 (NCVS Interviewing Manual for Field Representatives)_revised.pdf Interview Guide for Field Reps - Final IC Document
Attachment 5. NCVS-550 (NCVS Interviewing Manual for Field Representatives)_revised.pdf Interview Guide for Field Reps - Final IC Document
Attachment 7. BJS response to public comments_2.5.19.docx BJS Response to Public Comments IC Document
Attachment 7. BJS response to public comments_2.5.19.docx BJS Response to Public Comments IC Document
Request for OMB waiver of expiration date for 3 months_Feb 19.pdf Request for 3 month Waiver of Expiration Date IC Document
Request for OMB waiver of expiration date for 3 months_Feb 19.pdf Request for 3 month Waiver of Expiration Date IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	National Crime Victimization Survey, 2018-2021	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NCVS-1	Basic Screener Questionnaire	Attachment 2. NCVS-1 (Basic Screen Questionnaire)_revised.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	NCVS-2	Crime Incident Report	NCVS-2 (Crime Incident Report)_no expiration date.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	NCVS-500	Control Card	NCVS-500 (Control Card).pdf	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 172,258	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-344,516	344,516
Annual IC Time Burden (Hours)	-120,810	120,810
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NCVS Attachments	NCVS OMB Supporting Statement Attachments.pdf	03/20/2018
Letter to participants no expiration date	NCVS-572(L)_All Languages_no expiration date.pdf	06/14/2018
Follow up letter to participants no expiration date	NCVS-573(L)_All Languages_no expiration date.pdf	06/14/2018
Screen shot with no expiration date	NCVS Screenshot with OMB number_201803 instrument_no expiration date.pdf	06/14/2018
Final CAPI Self-Study NCVS-521	Attachment 3. NCVS-521 (CAPI Self-Study)_revised.pdf	02/08/2019
Initial Training Guide - Final	Attachment 4. NCVS-522(I) (Initial Training Guide)_revised.pdf	02/08/2019
Interview Guide for Field Reps - Final	Attachment 5. NCVS-550 (NCVS Interviewing Manual for Field Representatives)_revised.pdf	02/08/2019
BJS Response to Public Comments	Attachment 7. BJS response to public comments_2.5.19.docx	02/08/2019
Request for 3 month Waiver of Expiration Date	Request for OMB waiver of expiration date for 3 months_Feb 19.pdf	02/08/2019

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