Information Collection

Form 81-69,Community Visit Report

IC 182017 under ICR 200708-1660-004 · OMB 1660-0023.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0023 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 81-69 Form 81-69,Community Visit Report	Form
81-69 Community Visit Report 81-69.pdf	Form

IC Title:

Form 81-69,Community Visit Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	81-69	Community Visit Report	81-69.pdf		No		Printable Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,000

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	2,000	2,000
Annual IC Time Burden (Hours)	2,000	2,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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