OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

FEMA HMA Grant Survey (20311 A1)

IC 235089 under ICR 201805-1090-002 · OMB 1090-0007.

⚠️ Notice: This information collection may be referencing outdated material.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

2021-09-21 - Extension without change of a currently approved collection

Documents and Forms

Documents and forms in this information collection
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

View Information Collection (IC)

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:

table that charts list of 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

Federal Enterprise Architecture Business Reference Module

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 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	250	0	250	0	0	0
Annual IC Time Burden (Hours)	50	0	50	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
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.