Rap Back Services Form (1-796)

ICR 201502-1110-004

OMB: 1110-0067

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
New
Supplementary Document
2015-10-22
Supplementary Document
2015-10-22
Supplementary Document
2015-02-20
Supplementary Document
2015-02-20
Supporting Statement A
2015-10-22
IC Document Collections
IC ID
Document
Title
Status
215135 New
ICR Details
1110-0067 201502-1110-004
Historical Active
DOJ/FBI
Rap Back Services Form (1-796)
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 10/22/2015
Retrieve Notice of Action (NOA) 06/23/2015
  Inventory as of this Action Requested Previously Approved
10/31/2018 36 Months From Approved
6,000 0 0
300 0 0
0 0 0

DOJ's FBI CJIS Division is requesting a PRA approval for a new collection utilized by authorized agencies to enroll individuals in the Rap Back Service to ensure the submitting agency is notified when individuals in positions of trust engage in criminal conduct or individuals under the supervision of a criminal justice agency commit subsequent criminal acts.

None
None

Not associated with rulemaking

  80 FR 9753 02/24/2015
80 FR 25323 05/04/2015
No

1
IC Title Form No. Form Name
Rap Back Services Form 1-796 1-796, 1-796 (Fillable) Rap Back Services Form ,   Rap Back Services Form

  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 6,000 0 0 6,000 0 0
Annual Time Burden (Hours) 300 0 0 300 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new collection

$10,413
No
No
No
No
No
Uncollected
Marissa Barron 304 625-5347

  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.
06/23/2015


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