Form FEMA Form 009-0-91 FEMA Form 009-0-91 Project Worksheet - Damage Description and Scope of Work

DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY

PROJECT WORKSHEET - Damage Description and
Scope of Work Continuation Sheet
DISASTER
FEMA -

PROJECT NO.

PA ID NO.

DATE

-DR-

APPLICANT

PREPARED BY:

FEMA Form 009-0-91A, (4/2010)

COUNTY

TITLE

PREVIOUS EDITION OBSOLETE

O.M.B. NO. 1660-0017
Expires April 30, 2013

CATEGORY

PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this data collection is estimated to average 1.30 hours per response. The burden estimates includes time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting this
form. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send
comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections
Management, Department of Homeland Security, Federal Emergency Management Agency, 1800 South Bell Street, Arlington, VA
20598-3005, Paperwork Reduction Project (1660-0017). NOTE: Do not send your completed questionnaire to this address.