Information Collection

Medal of Valor Application

IC 219566 under ICR 202204-1121-007 · OMB 1121-0259.

Documents and Forms

Document Name Document Type
Medal of Valor Application Form and Instruction
Medal of Valor application MEDAL OF VALOR APPLICATION.doc www.ojp.usdoj.gov//medalofvalor/welcome.html. Form and Instruction
Medal of Valor application MEDAL OF VALOR APPLICATION.doc www.ojp.usdoj.gov//medalofvalor/welcome.html. Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Medal of Valor Application	Agency IC Tracking Number:	BJA

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	none	Medal of Valor application	MEDAL OF VALOR APPLICATION.doc	http://www.ojp.usdoj.gov//medalofvalor/welcome.html.	Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Leadership Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,705	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,705	1,705
Annual IC Time Burden (Hours)	710	710
Annual IC Cost Burden (Dollars)	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.