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

O.M.B. NO. 1660-0017
Expires July 31, 2016

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,
500 C Street, SW, Washington, DC 20472-3100, Paperwork Reduction Project (1660-0017). NOTE: Do not send your completed questionnaire to this
address.
DISASTER
FEMA -

PROJECT NO.

PA ID NO.

DATE

-DR-

APPLICANT

PREPARED BY:
FEMA Form 009-0-91A,

COUNTY

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