Information Collection

Fsr 253, Fsr 254, Fsr 255, Fsr 256, Fsr 257, Fsr 258, Fsr 259

IC 189241 under ICR 200905-1090-001 · OMB 1090-0008.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0008 can be found here:

Documents and Forms

Document Name Document Type
Form FSR 253 FSR 253, FSR 254, FSR 255, FSR 256, FSR 257, FSR 258, FSR 259 Form
FSR 253 DHS FEMA questionnaire FSR 253 DHS FEMA.xls Form
FSR 254 VA eBenefits questionnaire FSR 254 VA eBenefits.xls Form
FSR 255 State BCA Travel.State.gov questionnaire FSR 255 State BCA Travel.State.gov.xls Form
FSR 256 NIST Research.gov FSR 256 NIST Research.gov.xls Form
FSR 257 HHS NLM OSA questionnaire FSR 257 HHS NLM OSA.xls Form
FSR 258 USDA CNPP questionnaire FSR 258 USDA CNPP.xls Form
FSR 259 HHS CMS questionnaire FSR 259 HHS CMS.xls Form
Justification for ICs to generic ICR 1090-0008.doc Justification for ICs to generic ICR 1090-0008 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FSR 253, FSR 254, FSR 255, FSR 256, FSR 257, FSR 258, FSR 259	Agency IC Tracking Number:	FSR 253, 254, 255, 256, 257, 258, 259

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FSR 253	DHS FEMA questionnaire	FSR 253 DHS FEMA.xls	Yes	Yes	Fillable Fileable
Form	FSR 254	VA eBenefits questionnaire	FSR 254 VA eBenefits.xls	Yes	Yes	Fillable Fileable
Form	FSR 255	State BCA Travel.State.gov questionnaire	FSR 255 State BCA Travel.State.gov.xls	Yes	Yes	Fillable Fileable
Form	FSR 256	NIST Research.gov	FSR 256 NIST Research.gov.xls	Yes	Yes	Fillable Fileable
Form	FSR 257	HHS NLM OSA questionnaire	FSR 257 HHS NLM OSA.xls	Yes	Yes	Fillable Fileable
Form	FSR 258	USDA CNPP questionnaire	FSR 258 USDA CNPP.xls	Yes	Yes	Fillable Fileable
Form	FSR 259	HHS CMS questionnaire	FSR 259 HHS CMS.xls	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 35,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	35,000	35,000
Annual IC Time Burden (Hours)	1,458	1,458
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Justification for ICs to generic ICR 1090-0008	Justification for ICs to generic ICR 1090-0008.doc	05/20/2009

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