Information Collection

Video Survey and Answer Sheets - California and Montana

IC 46124 under ICR 200611-0596-002 · OMB 0596-0203.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Video Survey and Answer Sheets - California and Montana	Form
Answer Sheet - California - English Appendix B1 - Revised 8-24-06 Answer sheet California.doc	Form
Answer Sheet - California - Spanish Appendix B2 - Revised 8-24-06 Answer Sheet California Spanish.doc	Form
Answer Sheet Montana Appendix B3 - Revised 8-24-06 Answer sheet Montana.doc	Form
Video Survey	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	None	Answer Sheet - California - Spanish	Appendix B2 - Revised 8-24-06 Answer Sheet California Spanish.doc	No	Paper Only
Form	None	Answer Sheet Montana	Appendix B3 - Revised 8-24-06 Answer sheet Montana.doc	No	Paper Only
Form	None	Answer Sheet - California - English	Appendix B1 - Revised 8-24-06 Answer sheet California.doc	No	Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	500	500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Video Survey		11/21/2006

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.