Information Collection

Level 3 Evaluation Form for Students

IC 199124 under ICR 201102-1660-002 · OMB 1660-0132.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0132 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FF 092-0-2A Level 3 Evaluation Form for Students	Form and Instruction
FF 092-0-2A Level 3 Evaluation Form for Students Revised Level 3 student FEMA Form 092-0-02A.pdf www.cdp.dhs.gov	Form and Instruction

IC Title:

Level 3 Evaluation Form for Students

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FF 092-0-2A	Level 3 Evaluation Form for Students	Revised Level 3 student FEMA Form 092-0-02A.pdf	www.cdp.dhs.gov	Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,500

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	3,500	3,500
Annual IC Time Burden (Hours)	875	875
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.