Information Collection

Level 1 Assessment Form

IC 199122 under ICR 201503-1660-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 FEMA Form 092-0-2 Level 1 Assessment Form	Form and Instruction
FEMA Form 092-0-2 Level 1 Assessment Form Level 1 Assessment FEMA Form 092-0-2 Expiration Placeholder.pdf	Form and Instruction

IC Title:

Level 1 Assessment Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	FEMA Form 092-0-2	Level 1 Assessment Form	Level 1 Assessment FEMA Form 092-0-2 Expiration Placeholder.pdf		No		Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 38,000

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	38,000	-27,000	65,000
Annual IC Time Burden (Hours)	9,500	-6,750	16,250
Annual IC Cost Burden (Dollars)	0	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.