Information Collection

Immediate Disaster Case Management Intake Assessment

IC 231878 under ICR 202005-0970-010 · OMB 0970-0461.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ECMRS Paper Forms 20181227 new PRA Statement.docx	Other-Multiple Forms

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Immediate Disaster Case Management Intake Assessment

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 44 CFR Chapter I, Subchapter D 44 CFR 206.8 44 CFR 206.208(c)(2) 6 CFR 5 44 CFR 206.191 44 CFR 206.64 44 CFR 206.113 (To search for a specific CFR, visit the Code of Federal Regulations.)

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
Other-Multiple Forms			ECMRS Paper Forms 20181227 new PRA Statement.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 33,489

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	11,163	-618,837	630,000
Annual IC Time Burden (Hours)	11,163	-618,837	630,000
Annual IC Cost Burden (Dollars)	0	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.