Small Business Notice and Proof of Loss

ICR 200112-3067-002

OMB: 3067-0288

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
32114 Migrated
ICR Details
3067-0288 200112-3067-002
Historical Active 200105-3067-001
FEMA
Small Business Notice and Proof of Loss
Revision of a currently approved collection   No
Regular
Approved without change 02/15/2002
Retrieve Notice of Action (NOA) 12/27/2001
  Inventory as of this Action Requested Previously Approved
02/28/2005 02/28/2005 02/28/2002
400 0 1,250
400 0 625
0 0 0

This form is used by business claimants to notify FEMA that a Claimant has suffered damages of losses of $10,000 or less that the claimant asserts was caused by the Cerro Grande Fire to elect the Cerro Grands Fire Assistance Act (CGFAA), Public Law 106-246, as a claimant's exclusive remedy to redress those losses or damages. A claimant is not required to elect the CGFAA remedy but may elect to use the Federal Government under the Federal Tort claims Act.

None
None


No

1
IC Title Form No. Form Name
Small Business Notice and Proof of Loss FFCG-8

  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 400 1,250 0 0 -850 0
Annual Time Burden (Hours) 400 625 0 0 -225 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
12/27/2001


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