83-i

PAPERWORK REDUCTION ACT SUBMISSION
Please read the instructions before completing this form. For additional forms or assistance in completing this form, contact your agency's Paperwork
Clearance Officer. Send two copies of this form, the collection instrument to be reviewed, the Supporting Statement, and any additional documentation
to: Office of Information
Washington, DC 20503.
1. Agency/Subagency

and Regulatory

Affairs,

Office of Management

originating request

Docket Library,

1110
a. -----

3. Type of information collection (check one)

b. D

None

0006
- ---_

----

4. Type of review requested (check one)

a. D

New Collection

a.

b. D

Revision of a currently approved collection

b.

c. .{

Extension of a currently approved collection

d.

Reinstatement, without

[t]

c.

change, of a previously approved

Regular

D Emergency
D Delegated

- Approval requested by: _/_/_

5. Small entities

collection for which approval has expired

Will this information collection have a significant economic impact on a

Reinstatement, with change, of a previously approved

substantial number of small entities?

collection for which approval has expired
f. D

Room 10102, 725 17th Street NW,

2. OMB control number

DOJ/FBI

e. D

and Budget,

Yes

Existing collection in use without an OMB control number

For b-f, note Item A2 of Supporting Statement instructions

[?j Three

a.

years from the approval date

GZI

No

6. Requested expiration date
b.

I

--

I

L_

I

-_/_-

7. Title

Law Enforcement Officers Killed and Assaulted (LEOKA)
B. Agency form number(s) (if applicable)

1-705
9. Keywords

Officers killed, Officers assaulted, felonious, accidental, negligence
10. Abstract
Under Title 28, U.S.C., Sect. 534, this collection requests LEOKA data from federal, state, local, and other law enforcement
Program to serve as the national clearinghouse
for collection and dissemination
of data regarding law enforcement
officers
accidentally)
or assaulted while performing their duties.
11. Affected public (Mark primary with 'P' and all others with 'X')
a.

b. _ Business or other for-profit

d. - Farms
e. ~ Federal Government

c. _ Not-for-profit institutions

f.

-

Individuals or households

P

12. Obligation to respond (Mark primary with 'P' and all others that apply with 'X')
a.

Required to obtain or retain benefits

c. DMandatory
14. Annual reporting and record keeping cost burden (in thousands of dollars)

13. Annual reporting and record keeping hour burden

1 084
13008

b. Total annual responses

Ie]Voluntary

b.

State, Local, or Tribal Government

a. Number of respondents

agencies in order for the FBI's UCR
who are killed (feloniously or

a. Total annualized capital/startup

0
0
0
0
0

costs

b. Total annual costs (O&M)

1. Percentage of these responses

c. Total annualized cost requested

100

collected electronically

%

d. Current OMB inventory

1,517.6
7,552.3
-6,034.7

c. Total annual hours requested
d. Current OMB inventory
e. Difference

e. Difference
f. Explanation of difference

0
0

1. Program change

f. Explanation of difference

2. Adjustment

1. Program change

NIBRS

2. Adjustment

15. Purpose of information collection (Mark primary with 'P' and all others
that apply with 'X')
a. _ Application for benefits

e. _ Program planning or management

b. _ Program evaluation

f.

c. ..E. General purpose statistics

g. _ Regulatory or compliance

X

Research

d. - Audit

c.

D Recordkeeping
III Reporting:

b. D

Third party disclosure

1.

On occasion

2. D

Weekly

4.

Quarterly

Semi-annually

7.

Biennially

5.
B.

3.
6.

1l}10nthly

oAnnually

Other (describe)

1B. Agency contact (person who can best answer questions regarding the content

17. Statistical methods
Does this information collection employ statistical methods?
Yes .{

OMB 83-1

16. Frequency of record keeping or reporting (check all that apply)
a.

No

of this submission)
Name:

Malissa C. Vavra

Phone:

(304) 625-3010
10/95

19. Certification for Paperwork Reduction Act Submissions
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with
5 CFR 1320.9.
NOTE: The text of 5 CFR 1320.9, and the related provisions of 5 CFR 1320.8(b)(3), appear at the end of the
instructions. The certification is to be made with reference to those regulatory provisions as set forth in
the instructions.

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) If avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and record keeping practices;

(D

It indicates the retention periods for record keeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected (see note in Item 19 of the instructions);
(i) It uses effective and efficient statistical survey methodology (if applicable); and

OJ It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item below and explain the reason in
Item 18 of the Supporting Statement.

Signature of Senior Official or designee

OMB 83·1

Date

10/95