Information Collection

Request For Housing Accommodations

IC 181908 under ICR 201010-1660-006 · OMB 1660-0029.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0029 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FEMA Form 119-17-1 Request For Housing Accommodations	Form
FEMA Form 119-17-1 Request For Housing Accommodations FEMA Form 119-17-1 (previously 75-10) 11-19-2010.pdf www.fema.gov/help/forms.shtm	Form

IC Title:

Request For Housing Accommodations

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 44 CFR Part 15 (To search for a specific CFR, visit the Code of Federal Regulations.)

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	FEMA Form 119-17-1	Request For Housing Accommodations	FEMA Form 119-17-1 (previously 75-10) 11-19-2010.pdf	http://www.fema.gov/help/forms.shtm	Yes	Yes	Printable Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title: DHS/FEMA-017, Updating the Student Application and Registration System of Records

FR Citation: 69 FR 59609

Number of Respondents: 60

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	Previously Approved
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	6	6
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.