Information Collection

Family Members

IC 191876 under ICR 201001-0925-001 · OMB 0925-0612.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0612 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Family Members	Form and Instruction
1 database FoundinHaiti-1-Header.png	Form and Instruction
2 database FoundinHaiti-2.png	Form and Instruction
3 database FoundinHaiti-3.png	Form and Instruction
4 database FoundinHaiti-4.png	Form and Instruction
5 database FoundinHaiti-5.png	Form and Instruction

IC Title:

Family Members

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?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	database	FoundinHaiti-1-Header.png	Yes	Yes	Paper Only
Form and Instruction	2	database	FoundinHaiti-2.png	Yes	Yes	Paper Only
Form and Instruction	3	database	FoundinHaiti-3.png	Yes	Yes	Paper Only
Form and Instruction	4	database	FoundinHaiti-4.png	Yes	Yes	Paper Only
Form and Instruction	5	database	FoundinHaiti-5.png	Yes	Yes	Paper Only

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50,000

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	100,000	100,000
Annual IC Time Burden (Hours)	8,000	8,000
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.