Form FEMA Form 009-0-91 FEMA Form 009-0-91 Project Worksheet - Damage Description and Scope of Work

DEPARTMENT OF HOMELAND SECURITY

Federal Emergency Management Agency
PROJECT WORKSHEET
Damage Description and Scope of Work Continuation Sheet

O.M.B. Control Number: 1660-0017
Expires: December 31, 2019

PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this data collection is estimated to average 1.30 hours per response. The burden estimate includes the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting this form. This collection of information
is not required to obtain or retain benefits. You are not required to respond to this collection of information unless a valid OMB control number is displayed in the
upper right corner of this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information
Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street, SW., Washington, DC 20472, Paperwork
Reduction Project (1660-0017) NOTE: Do not send your completed form to this address.
DISASTER
FEMA -

PROJECT NO.

PA ID NO.

DATE

-DR-

APPLICANT

PREPARED BY:

FEMA Form 009-0-91A,

COUNTY

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