Public Safety Officer Suicide Reporting Module

The National Violent Death Reporting System (NVDRS)

Documents and Forms

Document Name Document Type
Public Safety Officer Suicide Reporting Module Form and Instruction
Public Safety Officer Suicide Module ATT7~S8D.PDF Form and Instruction

Information Collection (IC) Details

IC Title:	Public Safety Officer Suicide Reporting Module	Agency IC Tracking Number:

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 and Instruction	n/a	Public Safety Officer Suicide Module	ATT7~S8D.PDF		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	24,024	24,024
Annual IC Time Burden (Hours)	4,004	4,004
Annual IC Cost Burden (Dollars)	82,883	82,883

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.