Information Collection

FSR CMS 274, NCI 275, EPA 276, FEMA Main 277, eRule 278

IC 190935 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form FSR 275 FSR CMS 274, NCI 275, EPA 276, FEMA Main 277, eRule 278	Form
FSR 274 CMS Custom Questions 274 Custom Qs CMS 10-6-09.xls	Form
FSR 275 NCI Custom Questions 275 Custom Qs NCI 10-6-09.xls	Form
FSR 276 EPA New Model 276 EPA New Model 9.30.09 received 10-6-09.xls	Form
FSR 277 FEMA Main Custom Questions 277 FEMA Main V2 10-6-09.xls	Form
FSR 278 eRulemakng FDMS Custom Questions 278 eRulemaking FDMS Custom Qs 10-6-09.xlsx	Form

IC Title:

FSR CMS 274, NCI 275, EPA 276, FEMA Main 277, eRule 278

Agency IC Tracking Number:

FSR 274, FSR 275, FSR 276, FSR 277, FSR 278

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?	Can Be Submitted Electronically?	Electronic Capability
Form	FSR 275	NCI Custom Questions	275 Custom Qs NCI 10-6-09.xls	Yes	Yes	Fillable Fileable
Form	FSR 276	EPA New Model	276 EPA New Model 9.30.09 received 10-6-09.xls	Yes	Yes	Fillable Fileable
Form	FSR 277	FEMA Main Custom Questions	277 FEMA Main V2 10-6-09.xls	Yes	Yes	Fillable Fileable
Form	FSR 278	eRulemakng FDMS Custom Questions	278 eRulemaking FDMS Custom Qs 10-6-09.xlsx	Yes	Yes	Fillable Fileable
Form	FSR 274	CMS Custom Questions	274 Custom Qs CMS 10-6-09.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: 25,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25,000	25,000
Annual IC Time Burden (Hours)	1,042	1,042
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.