View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	National Elder Justice Prosecutor Survey	Agency IC Tracking Number:

IC Status: New

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	1103-0120	National Elder Abuse Survey	MDT Needs Survey Instrument v3 10.24.24 submitted to PRA_OMB comments slj2 TR COMMENTS 6 3 25.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	250	0	250	0	0	0
Annual IC Time Burden (Hours)	42	0	42	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Statement A	MDT Survey 10.24.24 ICR Template_A11 Section 280 Clearance v 5 13 24 2.18.25.docx	08/27/2025

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