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Congressional Badge of Bravery
LAW ENFORCEMENT OFFICERS CONGRESSIONAL BADGE OF BRAVERY
OMB: 1121-0330
IC ID: 209119
OMB.report
DOJ/OJP
OMB 1121-0330
ICR 202005-1121-003
IC 209119
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0330 can be found here:
2023-09-29 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Congressional Badge of Bravery
Form
Congressional Badge of Bravery application
cbob-application.jpg
Form
completion page
complete.jpg
Form
event form page
event-form.jpg
Form
nominator form page
nominator-form.jpg
Form
nominee form page
nominee-form.jpg
Form
supporting form page
supporting-form.jpg
Form
thanks page
thanks.jpg
Form
witness page
witness-form.jpg
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Congressional Badge of Bravery
Agency IC Tracking Number:
BJA
Is this a Common Form?
No
IC Status:
Unchanged
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
none
witness page
witness-form.jpg
Yes
Yes
Fillable Fileable
Form
none
Congressional Badge of Bravery application
cbob-application.jpg
Yes
Yes
Fillable Fileable
Form
none
completion page
complete.jpg
Yes
Yes
Fillable Fileable
Form
none
event form page
event-form.jpg
Yes
Yes
Fillable Fileable
Form
none
nominator form page
nominator-form.jpg
Yes
Yes
Fillable Fileable
Form
none
nominee form page
nominee-form.jpg
Yes
Yes
Fillable Fileable
Form
none
supporting form page
supporting-form.jpg
Yes
Yes
Fillable Fileable
Form
none
thanks page
thanks.jpg
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Law Enforcement
Subfunction:
Leadership Protection
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
164
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
164
0
0
0
0
164
Annual IC Time Burden (Hours)
55
0
0
0
0
55
Annual IC Cost Burden (Dollars)
0
0
0
0
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.