Debt Collection Financial Statement

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0011 can be found here:

Documents and Forms

Document Name Document Type
Form FEMA Form 127-0-1 Debt Collection Financial Statement Form
FEMA Form 127-0-1 Debt Collection Financial Statement FEMA Form 127-0-1 2017.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Debt Collection Financial Statement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FEMA Form 127-0-1	Debt Collection Financial Statement	FEMA Form 127-0-1 2017.pdf		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title: DHS/ALL-008 – Department of Homeland Security Accounts Receivable System of Records	FR Citation: 73 FR 61885

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	300	-1,700	2,000
Annual IC Time Burden (Hours)	225	-1,275	1,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.