FEMA HMA Grant Survey (20311 A1)

American Customer Satisfaction Index "Customer Satisfaction Surveys"

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0007 can be found here:

Documents and Forms

Document Name Document Type
Form 043 FEMA HMA Grant Survey (20311 A1) Form and Instruction
043 FEMA HMA Grant Survey FEMA HMA Survey Final 20190219.docx Form and Instruction
Generic Clearance Request Form-signed.pdf Generic Clearance Request Form IC Document
OMB Mapping Cover_20311 A1.xlsx OMB Mapping Cover IC Document

Information Collection (IC) Details

IC Title:	FEMA HMA Grant Survey (20311 A1)	Agency IC Tracking Number:	043

IC Status: New

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 and Instruction	043	FEMA HMA Grant Survey	FEMA HMA Survey Final 20190219.docx		Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Clearance Request Form	Generic Clearance Request Form-signed.pdf	02/25/2019
OMB Mapping Cover	OMB Mapping Cover_20311 A1.xlsx	02/25/2019

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