Information Collection

Community Emergency Preparedness Survey

IC 228844 under ICR 201807-0920-011 · OMB 0920-1221.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1221 Los Angeles County Community Emergency Preparedness Survey Community Emergency Preparedness Survey	Form and Instruction
Community Emergency Preparedness Survey - OMB Approved.docx	Other-WORD
Community Emergency Preparedness Survey_Spanish_7.11.18.docx	Other-WORD_Spanish Version
0920-1221 Los Angeles County Community Emergency Preparedness Surv Survey-Proposed Change 30MAR2018.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

0920-1221 (18ATL)

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	URL	Available Electronically?	Electronic Capability
Form and Instruction	0920-1221	NA	No	Paper Only
Other-WORD			No	Paper Only
Other-WORD_Spanish Version			No	Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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