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Deaths in Custody - Inmate Deaths in State Prisons
Mortality in Correctional Institutions
OMB: 1121-0249
IC ID: 219604
OMB.report
DOJ/OJP
OMB 1121-0249
ICR 201901-1121-001
IC 219604
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0249 can be found here:
2021-05-12 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form NPS-4
Deaths in Custody - Inmate Deaths in State Prisons
Form and Instruction
NPS-4 Annual Summary of Inmate Deaths in State Prisons
2015 NPS-4 form.pdf
Form and Instruction
NPS-4A State Prison Inmate Death Report
2016 NPS-4A Form_2015-10-09.pdf
Form and Instruction
Appendix C Attachments A-I.pdf
DCRP Appendix
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Deaths in Custody - Inmate Deaths in State Prisons
Agency IC Tracking Number:
BJS
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
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
NPS-4
Annual Summary of Inmate Deaths in State Prisons
2015 NPS-4 form.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
NPS-4A
State Prison Inmate Death Report
2016 NPS-4A Form_2015-10-09.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Correctional Activities
Subfunction:
Criminal Incarceration
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
3,646
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 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
0
0
-3,646
0
0
3,646
Annual IC Time Burden (Hours)
0
0
-1,723
0
0
1,723
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
DCRP Appendix
Appendix C Attachments A-I.pdf
01/19/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.