Information Collection

Adult Public - Cognitive Interview Screener

IC 231301 under ICR 202201-1660-002 · OMB 1660-0146.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FEMA Form 519-0-54 Adult Public - Cognitive Interview Screener	Form
FEMA Form 519-0-54 Post Disaster Survivor Preparedness Research FEMA Form 519-0-54 -jts 5-1-18.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

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
Form	FEMA Form 519-0-54 (Script)	Post Disaster Survivor Preparedness Research	FEMA Form 519-0-54 -jts 5-1-18.docx		No		Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-2,000	2,000
Annual IC Time Burden (Hours)	-80	80
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.