Debt Collection Financial Statement

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0011 can be found here:

Documents and Forms

Document Name Document Type
Form FEMA Form 127-0-1 Debt Collection Financial Statement Form
FEMA Form 127-0-1 Debt Collection Financial Statement FEMA Form 127-0-1, 3-28-2011.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Debt Collection Financial Statement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FEMA Form 127-0-1	Debt Collection Financial Statement	FEMA Form 127-0-1, 3-28-2011.pdf		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title: Privacy Act of 1974; Department of Homeland Security Accounts Receivable System of Records	FR Citation: 73 FR 61885

Number of Respondents: 1,600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,600	600	1,000
Annual IC Time Burden (Hours)	1,200	450	750
Annual IC Cost Burden (Dollars)	0	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.