Information Collection

State of Hawaii Hurricane Behavioral Survey

IC 234070 under ICR 201606-0710-001 · OMB 0710-0016.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0710-0016_Hawaii_Instrument.docx	Other-Survey
0710-0016_Hawaii_Instructions.docx	Instruction
0710-0016_Hawaii_One Pager.docx Request for Approval	IC Document
0710-0016_Hawaii_Phone Script.docx Telephone Script	IC Document
0710-0016_Hawaii_Coverletter_Mail.docx Cover Letter	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: New

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
Other-Survey			0710-0016_Hawaii_Instrument.docx		No		Paper Only
Instruction			0710-0016_Hawaii_Instructions.docx		No		Paper Only

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,200	2,200
Annual IC Time Burden (Hours)	1,100	1,100
Annual IC Cost Burden (Dollars)	7,986	7,986

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	0710-0016_Hawaii_One Pager.docx	11/19/2018
Telephone Script	0710-0016_Hawaii_Phone Script.docx	11/19/2018
Cover Letter	0710-0016_Hawaii_Coverletter_Mail.docx	11/19/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.