Federal Hotel and Motel Fire Safety Declaration Form

Forms and Documents

Document Name	Status
Form FF-USFA-FY-21-112 Federal Hotel and Motel Fire Safety Declaration Form Form and Instruction	Modified
Form FF-USFA-FY-21-112 Federal Hotel and Motel Fire Safety Declaration Form Form and Instruction	Modified
1660-0068 Published 30-Day Renewal FRN 2021 11 02.pdf Supplementary Document	2021-11-02
1660-0068 Published 60-Day Renewal FRN 2021 07 22.pdf Supplementary Document	2021-10-08
SORN DHS-ALL-004 GITAARS (77 FR 70792) 2012 11 27.pdf Supplementary Document	2021-10-08
privacy-pia-dhs-gcl-appendixbupdate-august2020.pdf Supplementary Document	2021-10-08
1660-0068 Supporting Statement A 2021 11 02 clean.docx Supporting Statement A	2021-11-02
Title 15 2224.pdf Supplementary Document	2015-04-21
Public Law 101-391.pdf Supplementary Document	2009-02-27

IC Document Collections

IC ID	Document Title	Status
21152	Federal Hotel and Motel Fire Safety Declaration Form Form and Instruction	Modified
188195	Federal Hotel and Motel Fire Safety Declaration Form Form and Instruction	Modified

ICR Details

OMB Control No: 1660-0068	ICR Reference No: 202110-1660-001
Status: Received in OIRA	Previous ICR Reference No: 201804-1660-001
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: Federal Hotel and Motel Fire Safety Declaration Form
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 11/02/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	02/28/2022
Responses	3,141	1,897
Time Burden (Hours)	836	523
Cost Burden (Dollars)	0	0

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Abstract: The Federal Hotel and Motel Fire Safety Declaration Form, FEMA Form FF-USFA-FY-21-112 (formerly 516-0-1), is used to collect basic information on life-safety systems related directly to fire-safety in hotels, motels, and similar places of accommodation applying for inclusion on the NML. In completing the form, applicants—property owners, lodging managers, or their delegates—provide basic information including identification of the owner(s) of the property, the business’s Employer Identification Number (EIN), and provisions for life-safety from fire. The form requests specific responses from applicants as to the installation of smoke alarms in all guestrooms of properties submitted for listing on the NML. In addition, applicants must indicate if the lodging establishment has an automatic fire sprinkler system where the building is four stories or higher. Once approved for the NML, the database record for each lodging establishment is assigned a unique identification number (FEMA ID). The information is collected and distributed through an on-line, electronic database accessed through the USFA website. Information submitted voluntarily by lodging establishments is reviewed and if the criteria meet the requirements of Public Law 101-391, they are given a FEMA ID number and listed in the NML database. Federal travelers and the public seeking public accommodation with provisions for life-safety from fire access the NML through the on-line database and identify lodging establishments in the area to which they are traveling.

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Authorizing Statute(s): PL: Pub.L. 101 - 391 3 Name of Law: Hotel and Motel Fire Safety Act of 1990
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 38733	07/22/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 60465	11/02/2021
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Federal Hotel and Motel Fire Safety Declaration Form	FF-USFA-FY-21-112 (formerly 516-0-1)	Federal Hotel and Motel Fire Safety Declaration Form (Review of Form)
Federal Hotel and Motel Fire Safety Declaration Form	FF-USFA-FY-21-112 (formerly 516-0-1)	Federal Hotel and Motel Fire Safety Declaration Form

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ICR Summary 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	3,141	1,897	0	1,244	0	0
Annual Time Burden (Hours)	836	523	0	313	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: The burden hours have increased based on the estimated number of respondents and responses from the last OMB submission. The current annual hour burden is 523 hours, the new hours burden is 838 for an increase of 315 annual hour burden.

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Annual Cost to Federal Government: $89,668

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.     No

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? No

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Common Form ICR:  No

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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: 11/02/2021

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