Information Collection

Licensee Request for Assistance [44 CFR 253.4]

IC 21081 under ICR 201511-1660-001 · OMB 1660-0024.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0024 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
44 CFR Part 352 Only (with relevant paragraphs highlighted in yellow).pdf	Instruction

IC Title:

Licensee Request for Assistance [44 CFR 253.4]

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 44 CFR 352.4

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
Instruction			44 CFR Part 352 Only (with relevant paragraphs highlighted in yellow).pdf		No		Printable Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title: DHS/ALL-002 Mailing and Other List System

FR Citation: 73 FR 71659

Number of Respondents: 1

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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	1	0	1
Annual IC Time Burden (Hours)	40	39	1
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.