Request for Mitigation Assistance

ICR 200103-3067-005

OMB: 3067-0286

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
32109 Migrated
ICR Details
3067-0286 200103-3067-005
Historical Active
FEMA
Request for Mitigation Assistance
New collection (Request for a new OMB Control Number)   No
Emergency 03/26/2001
Approved without change 04/26/2001
Retrieve Notice of Action (NOA) 03/20/2001
  Inventory as of this Action Requested Previously Approved
09/30/2001 09/30/2001
1,800 0 0
5,400 0 0
0 0 0

The request for Mitigation Assistance Form is used to carry out the purpose of the Cerro Grande Fire Assistance Act (CGFAA). Public Law 106-246 for mitigation compensation under 44 CFR 295.21(d)(3) of the final rule. Completion of the Request for Mitigation Assistance form will assist claimant, who seeks mitiation funds for damaged or destroyed residences and property. Claimant will complete the applicaiton and submit to FEMA. FEMA will utilize the information contained in the application to either fund or deny a claimants requests.

None
None


No

1
IC Title Form No. Form Name
Request for Mitigation Assistance CG-4

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,800 0 0 1,800 0 0
Annual Time Burden (Hours) 5,400 0 0 5,400 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (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;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/20/2001


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