Form CJ-5 OMBNo.1121‐0094ApprovalExpires06/2023
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT
RTI INTERNATIONAL
General Information
IMPORTANT: Please use this form as a reference and submit your data at https://bjsasj.rti.org.
If you are unable to submit data online, please return your completed form to us by email
(bjsasj@rti.org), fax (1-866-800-9179), or mail (RTI International, Attn: Data Capture, Annual Survey
of Jails (0216663), 5265 Capital Boulevard, Raleigh, NC 27690-1652.
For assistance, please contact RTI International at 1-866-354-4992 or bjsasj@rti.org.
2021 ANNUAL SURVEY OF JAILS
PointofContactatAgency:
OfficialAddress:
StreetorP.O.Bo
Cit
State Zip
reaCode Number Extension
Phone:
Email:
Agency/JailName:
Title FirstName LastName
BURDEN STATEMENT
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMB control number. The burden
of this collection is estimated to average 120 minutes per form, including reviewing instructions, searching existing data sources, gathering necessary data, and
completing and reviewing this form. Send comments regarding this burden estimate or any aspect of this survey, including suggestions for reducing this burden, to
the Director, Bureau of Justice Statistics, 810 Seventh Street, NW, Washington, DC 20531. Do not send your completed form to this address.
Facilities to include in this collection
Please include all confinement facilities administered by a
local or regional law enforcement agency. The facilities
are intended for adults but sometimes hold juveniles.
INCLUDE—
Jails and city/county or regional correctional centers.
Special jail facilities operated under the authority of local
or regional correctional authorities, including medical,
treatment, or release centers; halfway houses; work
farms; and private facilities operated under contract to
local, regional, or federal correctional authorities.
Temporary holding or lockup facilities if they are a part
of your combined jail function.
EXCLUDE—
Temporary holding or lockup facilities, from which
inmates are usually transferred within 72 hours and not
held beyond arraignment. If your only function is to hold
inmates temporarily, please contact us.
Reporting instructions
Most jails operate a single facility, but some jails operate
multiple facilities. Please complete this CJ-5 form on
information pertaining to all facilities under your jail
jurisdiction.
If the answer to a question is “not available” or
“unknown,” write “DK” in the space provided.
If the answer to a question is “not applicable,” write “NA”
in the space provided.
If the answer to a question is “none” or “zero,” write “0”
in the space provided.
When exact numeric answers are not available, provide
estimates, and mark X in the box beside each number
that is estimated, e.g., 1,234 .