Information Collection

Household Survey (Telephone) for General Public and Consent

IC 208428 under ICR 201403-0920-001 · OMB 0920-0993.

Documents and Forms

Document Name Document Type
Household Survey (Telephone) for General Public and Consent Form
Household Survey and Consent Revised Attachment D_ Household Survey for General Public and Consent.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Household Survey (Telephone) for General Public and Consent	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	none	Household Survey and Consent	Revised Attachment D_ Household Survey for General Public and Consent.docx		Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,440	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,440	3,440
Annual IC Time Burden (Hours)	1,433	1,433
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.