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Federal forms, ICRs, and supporting documents

Information Collection

Public Safety Officers' Disability Beneftis Application

IC 227412 under ICR 202401-1121-004 · OMB 1121-0220.

Documents and Forms
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Document Type
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Information Collection (IC) Details

View Information Collection (IC)

Public Safety Officers' Disability Beneftis Application BJA
 
No Unchanged
 
Voluntary
 

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

Community and Social Services Social Services

 

100 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 100 0 0 0 0 100
Annual IC Time Burden (Hours) 500 0 0 0 0 500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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