Information Collection

Open Ended Questionaire

IC 21134 under ICR 201103-1660-003 · OMB 1660-0057.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0057 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FEMA Form 142-1-2 Open Ended Questionaire Open Ended Questionaire	Form
FEMA Form 142-1-2 Open Ended Questionaire 1660-0057, 142 1-2.pdf	Form

IC Title:

Open Ended Questionaire

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation: 44 CFR 2.42

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 142-1-2				No		Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 170

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-170	170
Annual IC Time Burden (Hours)	-43	43
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.

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