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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.