Survivor Sheltering Assessment

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FEMA Form 009-0-42 Survivor Sheltering Assessment	Form and Instruction	Unchanged	Repair queued
1660-0142 Published 30 Day Revision FRN - 2021 02 24.pdf	Supplementary Document	Uploaded 2021-02-24	Repair queued
1660-0142 Published 60 Day FRN.pdf	Supplementary Document	Uploaded 2021-02-19	Repair queued
44 CFR 206 Part D (2010).pdf	Supplementary Document	Uploaded 2021-02-19	Repair queued
44 CFR 206.110 (2010).pdf	Supplementary Document	Uploaded 2021-02-19	Repair queued
42 USC Chap 68 (2010).pdf	Supplementary Document	Uploaded 2021-02-19	Missing upstream
42 USC 5174 (2010).pdf	Supplementary Document	Uploaded 2021-02-19	Missing upstream
Pub L 106-390 (114 Stat 1552) (2000).pdf	Supplementary Document	Uploaded 2021-02-19	Repair queued
Pub L 93-287 (88 Stat 143) (1974).pdf	Supplementary Document	Uploaded 2021-02-19	Repair queued
1660-0142 Supporting Statement A Revision 2021 02 24 clean.docx	Supporting Statement A	Uploaded 2021-02-24	Missing upstream

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
243459	Survivor Sheltering Assessment	Form and Instruction	Unchanged
228136	Survivor Sheltering Assessment Tool	Other-Survivor Sheltering Assessment Tool (App)	Unchanged

ICR Details

OMB Control No: 1660-0142	ICR Reference No: 202102-1660-004
Status: Received in OIRA	Previous ICR Reference No: 202009-1660-001
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: Survivor Sheltering Assessment
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 03/15/2021

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	03/31/2021
Responses	51,200	51,200
Time Burden (Hours)	8,535	8,535
Cost Burden (Dollars)	0	0

---

Abstract: This collection is used to collect information from survivors in shelters regarding the pre-disaster housing situation and post disaster housing plans. The information will be used by FEMA to understand the scope of the FEMA requirement to provide housing and rental assistance to those displaced by natural and manmade disaster. This will ensure that FEMA delivers housing and rental services without duplicating the benefits other Agencies are responsible for providing based on survivor’s pre-disaster housing situation. Aggregated reports will be used by staff in the Joint Field Office to plan and execute shelter depopulation strategies. Individual survivor information collected with this assessment will be used solely for the planning and delivery of FEMA services.

---

Authorizing Statute(s): PL: Pub.L. 93 - 288 0000 Name of Law: Name of Law: Robert T. Stafford Disaster Relief and Emergency Assistance Act
   US Code: 42 USC 5174 Name of Law: Disaster Mitigation Act of 2000
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 80126	12/11/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 11310	02/24/2021
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Survivor Sheltering Assessment Tool
Survivor Sheltering Assessment	FEMA Form 009-0-42AV	Survivor Sheltering Assessment Alternate Version

---

ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	51,200	51,200	0	0	0	0
Annual Time Burden (Hours)	8,535	8,535	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $307,884

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Yes

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/15/2021

---