Environmental and Historic Preservation Screening Form

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FEMA Form 024-0-1 Environmental and Historic Preservation Screening Form	Form and Instruction	Modified	Available
Form FEMA Form 024-0-1 Environmental and Historic Preservation Screening Form	Form and Instruction	Modified	Available
Supporting Statement for OMB Collection 1660-0115 Part A (OCC RAD cleared verison).doc	Supporting Statement A	Uploaded 2017-01-30	Repair queued
DHS_Instruction Manual 023-01-001-01 Rev 01_508compliantversion.pdf	Supplementary Document	Uploaded 2017-01-18	Available
FEMA EHP INSTRUCTION (108-1-1) FINAL, 07 25 16_508_signed.pdf	Supplementary Document	Uploaded 2017-01-18	Available
42 USC Sec 4332.pdf	Supplementary Document	Uploaded 2017-01-18	Available
16 USC Sec 470f.pdf	Supplementary Document	Uploaded 2017-01-18	Available
Public Law 89-665.pdf	Supplementary Document	Uploaded 2017-01-18	Available
FEMA NoC Document Narrative of Changes for OMB Collection 1660-0115.docx	Supplementary Document	Uploaded 2017-01-18	Available
Revised_GPD EHP_Forms Revision Chart_Jan 2017.doc	Supplementary Document	Uploaded 2017-01-18	Available
privacy_PIA_FEMA_GrantManagementPrograms_February2015.pdf	Supplementary Document	Uploaded 2017-01-30	Available
Published 30 Day FRN for OMB Collection 1660-0115, 1-6-2017.pdf	Supplementary Document	Uploaded 2017-01-18	Available
Published 60 Day FRN for OMB Collection 1660-0115, 10-26-2016.pdf	Supplementary Document	Uploaded 2017-01-18	Available
Public Law 102-575.pdf	Supplementary Document	Uploaded 2017-01-18	Available
NEPA69, Public Law 91-190, Sec 102.pdf	Supplementary Document	Uploaded 2017-01-18	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
193701	Environmental and Historic Preservation Screening Form	Form and Instruction	Modified
193035	Environmental and Historic Preservation Screening Form	Form and Instruction	Modified

ICR Details

OMB Control No: 1660-0115	ICR Reference No: 201612-1660-003
Status: Active	Previous ICR Reference No: 201307-1660-005
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: Environmental and Historic Preservation Screening Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/28/2017
	Date Received in OIRA: 01/31/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2020	36 Months From Approved	04/30/2017
Responses	2,000	0	3,000
Time Burden (Hours)	16,000	0	24,000
Cost Burden (Dollars)	0	0	0

---

Abstract: In efforts to examine the impact of its actions on the environment, look at potential alternatives to that action, inform both decision-makers and the public of those impacts through a transparent process, and pursue mitigation if necessary, grant recipients need to provide information that their actions will comply with all related laws and regulations.

---

Authorizing Statute(s): PL: Pub.L. 91 - 190 Title I Name of Law: National Environmental Policy Act of 1969
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 74462	10/26/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 1747	01/06/2017
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Environmental and Historic Preservation Screening Form	FEMA Form 024-0-1	Environmental and Historic Preservation Screening Form
Environmental and Historic Preservation Screening Form	FEMA Form 024-0-1	Environmental and Historic Preservation Screening Form

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,000	3,000	0	0	-1,000	0
Annual Time Burden (Hours)	16,000	24,000	0	0	-8,000	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: There has been no change to the information being collected. However, there has been a decreased in the number of respondents and annual burden hours due to a decrease in grant funding over the past two grant years. FEMA Form 024-0-1 had a few minor changes. Two statements have been removed due to new policy documents which supersede the Information Bulletins; FEMA EHP Instruction 108-1-1 and DHS Instruction Manual 023-01-001-01.

---

Annual Cost to Federal Government: $5,504,580

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/31/2017

---