Notice of Loss- Cerro Grande Fire Assistance Act

ICR 200303-1660-049

OMB: 1660-0049

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
21123 Migrated
ICR Details
1660-0049 200303-1660-049
Historical Active 200112-3067-004
DHS/FEMA
Notice of Loss- Cerro Grande Fire Assistance Act
Revision of a currently approved collection   No
Regular
Approved without change 03/01/2003
Retrieve Notice of Action (NOA) 03/01/2003
  Inventory as of this Action Requested Previously Approved
02/28/2005 02/28/2005
22,000 0 0
17,000 0 0
0 0 0

The Notice of loss is the form used to notify FEMA that a claimant has suffered injury, damage or loss that the claimant asserts was caused by the Cerro Grande Fire and to elect the Cerro Grande Fire Assistance Act (CGFAA), Public Law 106,246, as a claimant's exclusive remedy to redress loss, injury and damages caused by the Cerro Grande Fire. 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
Notice of Loss- Cerro Grande Fire Assistance Act FFCG-1

  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 22,000 0 0 22,000 0 0
Annual Time Burden (Hours) 17,000 0 0 17,000 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.
03/01/2003


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