Level 3 Evaluation Form for Students

Level 1 Assessment and Level 3 Evaluations for the Center for Domestic Preparedness (CDP)

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.