Form FEMA Form FF-008-F FEMA Form FF-008-F Preparedness Activity Feedback Form

Preparedness Activity Registration and Feedback

FEMA Form FF-008-FY-23-102 (formerly 519-0-11).xlsx

Preparedness Activity Feedback Form

OMB: 1660-0134

Document [xlsx]
Download: xlsx | pdf

Overview

Rollup
Question Bank
PRA Tables


Sheet 1: Rollup

Category Initiative Count of Question
Activity Details
61

AP Satisfaction 29

Create Activity 16

Ready 2 Help 5

Until Help Arrives 7

Materials Ordering 3

CBO Training 1
Feedback
34

AP Satisfaction 18

Until Help Arrives 6

Experience 10
Future Communication
3

Ready 2 Help 1

Until Help Arrives 2
Information Text
5

AP Satisfaction 2

Materials Ordering 3
POC Information
27

Create Account 14

Create Activity 4

Materials Ordering 9
Order Form
3

Materials Ordering 3
Course Feedback
8

CBO Training 8
Material Download
7

CBO Training 7
Total Result
148

Sheet 2: Question Bank

Initiative Question Response Category Sub Category Notes 112-2-1 Reference
AP Satisfaction Did you complete a preparedness action as part of America's PrepareAthon!? Yes No (Skip to question 12) Activity Details

Existing - Not Used
AP Satisfaction On which hazard(s) did you focus your Day of Action? Tornado
Flood
Hurricane
Wildfire
Earthquake
Hazardous material release
Winter weather / Ice storm
Extreme heat
Other
Activity Details Content
Existing - Not Used
AP Satisfaction What activities did you do? (check all that apply) Found out what disasters might happen in my community
Learned about and signed up for local alerts and warnings
Learned what to do to protect yourself for the hazards in my community
Developed, updated, or practiced your family/household communications plan
Collected and updated critical documents you might need
Collected, updated, refreshed your emergency tools and supplies
Signed up to take training in first aid, CPR, AED, CERT
Planned, reviewed, and practiced your evacuation route and transportation plans
Identified and practiced taking shelter in a protective location
Took steps to protect your home and personal property
Met with friends and family to discuss preparing
Other
Activity Details Content
Existing - Not Used
AP Satisfaction How many adults in your household participated in the activity?
Activity Details Number Participants
Existing - Not Used
AP Satisfaction How many youth in your household participated in the activity?
Activity Details Number Participants
Existing - Not Used
AP Satisfaction Did you do more, less, or what you indicated you would do in your registration? More
Less
Same
Activity Details Content
Existing - Not Used
AP Satisfaction Which America's PrepareAthon! resources did you use to plan and conduct your Day of Action? (check all that apply) America's PrepareAthon! preparedness materials:
How to Prepare Guide
Individual and Family Playbook
Resource Guide for Alerts and Warnings
Other materials
Activity Details Other
Existing - Not Used
AP Satisfaction Have you visited the National Preparedness Community discussion boards since you registered to participate in America's PrepareAthon? Yes
No
I don't know
Activity Details Other
Existing - Not Used
AP Satisfaction Did you participate in any social media related to America's PrepareAthon? Yes
No
Activity Details Other
Existing - Not Used
AP Satisfaction In what state are you located?
Activity Details Location
Existing - Not Used
AP Satisfaction In what zip code are you located?
Activity Details Location
Existing - Not Used
AP Satisfaction Please select the category that best describes your organization from the following list: Access/Functional/Disability Needs Organizations Medical Reserve Corps
Animal Shelter/Service Providers
Businesses/Industry Associations
Media Organizations
Military
Museums/Libraries/Parks etc.
Non-profit Organizations
Pets/Livestock/Agriculture
Preparedness Organizations
Red Cross Chapter
Science/engineering organizations
Scouting Groups
Senior Facilities/Communities
State Government
Tribes/Tribal Leadership
Youth Organizations
VOAD (Voluntary Organizations Active in Disasters)
Volunteer Radio Clubs
Volunteer Organizations/Service Clubs
Other
CERT Groups
Childcare and Preschool
Citizen Corps Council
Colleges/Universities
Communication Groups
Congressional
Faith-based Organizations
Federal Government
Fire/Emergency Responders
Healthcare
HOA/Neighborhood Groups
Individuals/Families
K-12 Schools and Districts
Local Government
Media Organizations
Activity Details Audience Type
Existing - Not Used
AP Satisfaction [K-12 Schools and Districts Only] Which best describes your school? Public
Private
Other (Please specify)
Activity Details Audience Type
Existing - Not Used
AP Satisfaction [Volunteer Organizations Only] Which level do you represent? Chapter/Local
Headquarters/National
Not applicable
Other
Activity Details Audience Type
Existing - Not Used
AP Satisfaction [Private Sector Only] How many employees does your business have? 1 - 99
100 - 499
500 - 1,499
1500 - 4,999
5,000 - or more
Activity Details Number Participants
Existing - Not Used
AP Satisfaction In addition to registering your participation, which of the following did the America's PrepareAthon! website, www.ready.gov/prepare
help you to do? (select all that apply)
Download/print resources
Learn about hazards in my area
Learn what I should do to prepare
Download/print resources
Learn about preparedness activities in my state/community
Learn about the organizations supporting America's PrepareAthon!
Learn about research in emergency preparedness
Share my participation in America's PrepareAthon! with others
Print a certificate of participation
Other (please specify)
I did not use the America's PrepareAthon! website
Activity Details Resources
Existing - Not Used
AP Satisfaction Did you complete a preparedness action as part of America's PrepareAthon!? Yes
No (Skip to Question 13)
Activity Details Other
Existing - Not Used
AP Satisfaction On which hazard(s) did you focus your Day of Action? Tornado
Flood
Hurricane
Wildfire
Earthquake
Hazardous material release
Winter weather / Ice storm
Extreme heat
Other
Activity Details Hazards
Existing - Not Used
AP Satisfaction What activities did you conduct? (check all that apply) Conducted a tabletop exercise to test your organizational readiness (e.g. emergency response plans, continuity plans,
communications systems)
Conducted training for people in your organization to support organizational preparedness and response
Conducted an educational discussion for the people in your organization for their personal and household preparedness
Conducted a drill for the people in your organization for their personal and household preparedness
Conducted a training for the people in your organization for their personal and household preparedness
Other
Activity Details Content
Existing - Not Used
AP Satisfaction How many adults in your organization participated in the activity?
Activity Details Number Participants
Existing - Not Used
AP Satisfaction How many youth in your organization participated in the activity?
Activity Details Number Participants
Existing - Not Used
AP Satisfaction Did your organization do more, less, or what you indicated you would do in your registration? I don't know
Same
Less
More
Activity Details Content
Existing - Not Used
AP Satisfaction Which America's PrepareAthon! resources did you use to plan and conduct your Day of Action? (check all that apply) America's PrepareAthon! preparedness materials:
How to Prepare Guide
Playbook
Day of Action Guide: Prepare Your People
Day of Action Guide: Prepare Your Organization
Resource Guide for Alerts and Warnings
Other
Activity Details Resources
Existing - Not Used
AP Satisfaction Have you visited the National Preparedness Community discussion boards since you registered to participate in America's
PrepareAthon?
Yes
No
I don't know
Activity Details Resources
Existing - Not Used
AP Satisfaction Did you participate in any social media related to America's PrepareAthon? Yes
No
Activity Details Other
Existing - Not Used
AP Satisfaction Which America's PrepareAthon promotional materials did you use? (check all that apply) Posters
Web banners
Digital invites
None
Activity Details Resources
Existing - Not Used
AP Satisfaction Did you customize any of these materials? Yes
No
Activity Details Resources
Existing - Not Used
AP Satisfaction In what state is your organization located?
Activity Details Location
Existing - Not Used
AP Satisfaction In what zip code is your organization located?
Activity Details Location
Existing - Not Used
AP Satisfaction In addition to registering your participation, which of the following did the America's PrepareAthon! website, www.ready.gov/
prepare help you to do? (select all that apply)
Learn about hazards in my area
Learn what I should do to prepare
Download/print resources
Learn about preparedness activities in my state/community
Learn about the organizations supporting America's PrepareAthon!
Learn about research in emergency preparedness
Share my participation in America's PrepareAthon! with others
Print a certificate of participation
Other (please specify)
I did not use the America's PrepareAthon! website
Feedback

Existing - Not Used
AP Satisfaction How satisfied were you with your ability to find what you were looking for? Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Not applicable
Feedback

Existing - Not Used
AP Satisfaction [If “Dissatisfied” or “Very dissatisfied”] What would have made it easier to find what you were looking for? [open-ended] Free Text Feedback

Existing - Not Used
AP Satisfaction How helpful were these materials for planning and conducting your Day of Action? Extremely helpful
Very helpful
Somewhat helpful
A little helpful
Not at all helpful
Feedback

Existing - Not Used
AP Satisfaction How satisfied are you with how easy it was to get involved in America's PrepareAthon? Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
Feedback

Existing - Not Used
AP Satisfaction Are you more prepared as a result of participating in America's PrepareAthon? A great deal more prepared
Somewhat more prepared
No change to my level of preparedness
I am more confused about how to prepare
Not sure
Feedback

Existing - Not Used
AP Satisfaction Do you plan to participate in the next America's PrepareAthon? Yes
No
Not sure
Feedback

Existing - Not Used
AP Satisfaction Would you encourage others to participate? Yes
No
Feedback

Existing - Not Used
AP Satisfaction What suggestions do you have for the next America's PrepareAthon? Free Text Feedback

Existing - Not Used
AP Satisfaction How satisfied were you with your ability to find what you were looking for? Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
Not applicable
Feedback

Existing - Not Used
AP Satisfaction [If “Dissatisfied” or “Very dissatisfied”] What would have made it easier to find what you were looking for? Free Text Feedback

Existing - Not Used
AP Satisfaction How helpful were these materials for planning and conducting your Day of Action? Not at all helpful
A little helpful
Somewhat helpful
Very helpful
Extremely helpful
Feedback

Existing - Not Used
AP Satisfaction [If yes] How easy was it to customize? Very easy
Easy
Neither easy nor difficult
Difficult
Very difficult
Feedback

Existing - Not Used
AP Satisfaction How satisfied are you with how easy it was to get involved in America's PrepareAthon? Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
Feedback

Existing - Not Used
AP Satisfaction Are you more prepared as a result of participating in America's PrepareAthon? A great deal more prepared
Somewhat more prepared
No change to my level of preparedness
I am more confused about how to prepare
Not sure
Feedback

Existing - Not Used
AP Satisfaction Do you plan to participate in the next America's PrepareAthon? Yes
No
Not sure
Feedback

Existing - Not Used
AP Satisfaction Would you encourage others to participate? Yes
No
Feedback

Existing - Not Used
AP Satisfaction What suggestions do you have for the next America's PrepareAthon?
Feedback

Existing - Not Used
AP Satisfaction Thank you very much for your time! We appreciate your willingness to provide feedback to help make the next America's PrepareAthon! an
even greater success. Congratulations on doing your part to be prepared!

Information Text

Existing - Not Used
AP Satisfaction Thank you for registering to participate in America's PrepareAthon! Because you registered to participate we are contacting you to complete
this survey. This survey is intended to help us assess and improve the usefulness of America's PrepareAthon! website, guides and other
resources.
This survey is voluntary and anonymous; your answers will not be linked to your name or email address. The IP address for the computer you
use will be collected with your answers, but this information will be deleted later to protect your privacy.
This survey will be closed on [Month, Day]. Please complete it before that date. You may quit the survey at any time by clicking “Exit this
Survey.” You can stop and return later on the same computer to change or complete your entries, up until [Month, Day].
The survey should take about 10 minutes. You must be at least 18 years old to participate.
If you have any questions or comments about this survey, please contact [email protected].

Information Text

Existing - Not Used
CBO Training Number of represented organizations 1-4
5-9
10-14
15+
Activity Details Number Participants
New
CBO Training How many times will you teach this course? 1
2-3
4-5
6+
Material Download Frequency
New
CBO Training Estimated number of learners per course? 1-10
11-20
21-30
30-40
40+
Material Download Number Participants
New
CBO Training Zip code of delivery? Please, enter zip code of first delivery if offering more than one Free Text Material Download Location
New
CBO Training Audience type? (select all that apply)
Service Organization (i.e. food bank; soup kitchen, goods donation)
Faith-Based Organization; school; child aftercare facility; assisted living center
Business
Other (with free text)
Material Download Audience Type
New
CBO Training Age range of learners? (select all that apply) Under 12
12-18
18-30
30-50
50+
Material Download Age
New
CBO Training Which modules do you plan to teach? (select all that apply) Modules TBD; may be up to ten modules so this would be modules 1-10 Material Download Content
New
CBO Training Would you like to receive additional information about emergency preparedness? Yes
No
If yes, please provide your email address:
Material Download

New
CBO Training This course taught me valuable concepts. Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Please provide additional comments below.
Course Feedback Feedback
New
CBO Training After taking this course, I am more likely to take steps to prepare my community based organization for emergencies and disasters Agree
Disagree
Course Feedback

New
CBO Training Which modules did you complete? (select all that apply) Modules TBD; may be up to ten modules so this would be modules 1-10 Course Feedback

New
CBO Training What could make this course better? Free Text Course Feedback

New
CBO Training Why did you take this course? (select all that apply) To fulfill a requirement
To broaden my understanding and awareness
To improve my organization's response in an emergency situation
To increase my level of comfort in continuing service during an emergency
Course Feedback

New
CBO Training How did you hear about this course? (select all that apply) Internet search
Word of mouth
Advertisement
Social Media
Other
Course Feedback

New
CBO Training Would you like to receive additional information about emergency preparedness? Yes
No
If yes, please provide your email address:
Course Feedback

New
CBO Training How do you want your name to appear on your certificate? Free Text Course Feedback

New
Create Account Username/Email Address Free Text POC Information

Existing - In use
Create Account Confirm Email Address Free Text POC Information

Existing - In use
Create Account Password Free Text POC Information

Existing - In use
Create Account Confirm Password Free Text POC Information

Existing - In use
Create Account First Name Free Text POC Information

Existing - In use
Create Account Last Name Free Text POC Information

Existing - In use
Create Account Organization Name Free Text POC Information

Existing - In use
Create Account City Free Text POC Information

Existing - In use
Create Account Country Select POC Information

Existing - In use
Create Account State Select POC Information

Existing - In use
Create Account I would like my name/organization to appear on the FEMA Preparedness Portal website as a supporter. Yes
No
POC Information

Existing - In use
Create Account I affirm that I meet the age requirements for joining and am 18 years of age or older, or I am a parent/guardian/sponsor registering on behalf of a minor under 18 years of age.
I have read and accept the site's Terms and Conditions.
I agree to the Trademark Consent to Use Agreement and agree to adhere to the Logo Usage Guidelines.
I affirm that the above information is true and correct to the best of my knowledge. I understand that this information is covered by the Privacy Act statement, above.

I affirm that I meet the requirements for joining.*
Yes
No
POC Information

Existing - In use
Create Account Time Zone
POC Information
Select the desired local time and time zone. Dates and times throughout this site will be displayed using this time zone. Existing - In use
Create Account To prevent automated SPAM submissions, please prove that you are a human by filling out the text box below based on the image displayed. I'm not a robot POC Information
Powered by reCAPTCHA Existing - In use
Create Activity Title Free Text Activity Details Unique Details
Existing - In use
Create Activity Sutitle Free Text Activity Details Unique Details
Existing - In use
Create Activity Description Free Text Activity Details Unique Details **Do not enter sensitive Personal Identifiable Information (PII) such as SSN, address, phone number, DOB or driver's license number. Refer to the FEMA Privacy Policy. Existing - In use
Create Activity This is a 2018 National Level Exercise (NLE) activity Yes
No
Activity Details Content
Existing - In use
Create Activity Activity Access Alerts and Warnings
Assemble or Update Supplies
Conduct an Exercise
Document and Insure Property
Drill or Practice Emergency Response
Make Property Safer
Participate in a Class, Training, or Discussion
Plan with Neighbors
Safeguard Documents
Test Communication Plans
Other
Activity Details Content
Existing - In use
Create Activity Audiences * Child Care Center, School, College/University
Faith-Based Organization
Individual/Family/Neighborhood
Military
Non-Profit/Volunteer Organization
Private Sector/Business
Public Sector/Government (non-military)
Whole Community Event (multiple sectors participating)
Other
Activity Details Audience Type
Existing - In use
Create Activity Hazards * Active Shooter
Earthquake
Flood
Hurricane
Tornado
Wildfire
Winter Storm
Other
Activity Details Hazards
Existing - In use
Create Activity Activity Details: When All Day
Show End Date
Date (mm/dd/yyyy)
Time
Activity Details When
Existing - In use
Create Activity This is an online activity and does not have a geographic address Yes
No
Activity Details Location
Existing - In use
Create Activity Activity Details: Where Country
Address 1
Address 2
City
State
Zip Code
Activity Details Location
Existing - In use
Create Activity Participants Free Text Activity Details Number Participants
Existing - In use
Create Activity Are participants in multiple locations? None
No
Across City/County
Across State
Across Country
Activity Details Location
Existing - In use
Create Activity Is this activity public? Public
Private
Activity Details Where Public activities will be displayed in the activities calendar and America&s PrepareAthon! website. Existing - In use
Create Activity URL Free Text Activity Details Unique Details If there is a web page where people can find more information about the activity, enter the link here. Existing - In use
Create Activity URL Title Free Text Activity Details Unique Details The link title is limited to 128 characters maximum. Existing - In use
Create Activity Are you doing this activity in affiliation with another organization or campaign? Yes
No
Activity Details Unique Details
Existing - In use
Create Activity Will you be the point of contact for this activity? Yes
No
POC Information

Existing - In use
Create Activity Please enter the name, organization and email address of the contact person for this activity.
Name
Free Text POC Information

Existing - In use
Create Activity Organization Free Text POC Information

Existing - In use
Create Activity Email Free Text POC Information

Existing - In use
Experience Overall, how well does the site meet your needs? Likert Scale Feedback Web User
New
Experience How easy was it to find what were looking for? Likert Scale Feedback Web User
New
Experience Did it take you more or less time than you expected to find what you were looking for on our website? Likert Scale Feedback Web User
New
Experience How visually appealing in our website? Likert Scale Feedback Web User
New
Experience How easy it is to understand the information on our website? Likert Scale Feedback Web User
New
Experience How much do you trust the information on our website? Likert Scale Feedback Web User
New
Experience How likely is it that you would recommend our website to a friend or colleague? Likert Scale Feedback Web User
New
Experience What is your reason for visiting our site today? Preparedness Program
Research
Hazards
Feedback Web User
New
Experience Did you accomplish your goal for visiting our site? Yes
Yes, after searching for some time
No
Feedback Web User
New
Experience Why have you decided to exit the site? I found what I needed
I can't find what I need
I'm confused by the information
I want to tell others
Feedback Web User
New
Materials Ordering Is this request to support a scheduled training? Yes
No
Activity Details

New
Materials Ordering Start date of scheduled training
Activity Details

New
Materials Ordering Please describe training Free Text Activity Details

New
Materials Ordering Instructions for Requesting Publications Use the tables on the following pages to enter the quantity of each publication being requested. All requests require FEMA approval prior to shipment. Allow 2–3 weeks for delivery.
Information Text

New
Materials Ordering Community Emergency Response Team (CERT)To receive printed CERT training materials, the CERT team must be registered in the CERTNational Database. Teams can register at https://community.fema.gov/Register.The publication requester name must match the point of contact listed in the CERT National Database
Information Text

New
Materials Ordering Contact Us To place an order, requesters must send the completed and signed order form via email, fax, or the U.S. Postal Service. Requesters may also call for assistance. Contact Information Email: [email protected]: 719-295-2676 Fax: 719-948-9724 Mail: Pueblo Distribution Center 31451 United Ave. Pueblo, CO 81001
Information Text

New
Materials Ordering Organization/Agency/Company Name
POC Information

New
Materials Ordering Requestor Name
POC Information

New
Materials Ordering Job Title/Position
POC Information

New
Materials Ordering Email Address
POC Information

New
Materials Ordering Delivery Address
POC Information

New
Materials Ordering City
POC Information

New
Materials Ordering State
POC Information

New
Materials Ordering Zip Code
POC Information

New
Materials Ordering Phone Number
POC Information

New
Materials Ordering Publication Number
Order Form

New
Materials Ordering Publication Title
Order Form

New
Materials Ordering Quantity Requested
Order Form

New
Ready 2 Help How many times will you play this game? 1
2-3
4-5
6+
Activity Details Frequency
New
Ready 2 Help Total estimated number of participants 1-10
11-20
21-30
30-40
40+
Activity Details Number Participants
New
Ready 2 Help Zip code of delivery: Please enter the zip code of the first delivery if providing multiple deliveries. Free Text Activity Details Location
New
Ready 2 Help Audience type? (select all that apply) School
Afterschool program
Youth Organization
Faith-Based Organization
Other
Activity Details Audience Type
New
Ready 2 Help Age range of learners: (select all that apply) Under 6
6-8
8-10
10-12
12-14
14+
Activity Details Age
New
Ready 2 Help Would you like to receive additional information about emergency preparedness? Yes
No
If yes, please provide your email address:
Future Communication

New
Until Help Arrives How many times will you teach this course? 1
2-3
4-5
6+
Activity Details Frequency
New
Until Help Arrives Estimated number of learners per course? 1-10
11-20
21-30
30-40
40+
Activity Details Number Participants
New
Until Help Arrives Zip code of delivery? Please, enter zip code of first delivery if offering more than one Free Text Activity Details Location
New
Until Help Arrives Audience type? (select all that apply) Student
Local Government
Youth Organization
Faith-Based Organization
Business
General Public
Other
Activity Details Audience Type
New
Until Help Arrives Age range of learners? (select all that apply) Under 12
12-18
18-30
30-50
50+
Activity Details Age
New
Until Help Arrives Which modules do you plan to teach? (select all that apply) Module 1: You Make a Difference
Module 2: Call 9-1-1
Module 3: Stay Safe
Module 4: Stop the Bleeding
Module 5: Position the Injured
Module 6: Provide Comfort
Activity Details Content
New
Until Help Arrives How do you want your name to appear on your certificate? Free Text Activity Details Unique Details
New
Until Help Arrives This course taught me valuable concepts. Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Please provide additional comments below.
Feedback

New
Until Help Arrives After taking this course, I am more likely to provide help to an injured person in an emergency situation. Agree
Disagree
Feedback

New
Until Help Arrives Which modules did you complete? (select all that apply) Module 1: You Make a Difference
Module 2: Call 9-1-1
Module 3: Stay Safe
Module 4: Stop the Bleeding
Module 5: Position the Injured
Module 6: Provide Comfort
Feedback

New
Until Help Arrives What could make this course better? Free Text Feedback

New
Until Help Arrives Why did you take this course? (select all that apply) To fulfill a requirement
To broaden my understanding and awareness
To improve my response in an emergency situation
To increase my level of comfort in providing emergency medical care
To satisfy my curiosity
Feedback

New
Until Help Arrives How did you hear about this course? (select all that apply) Internet search
Word of mouth
Advertisement
Social Media
Other
Feedback

New
Until Help Arrives Would you like to receive additional information about emergency preparedness? Yes
No
If yes, please provide your email address:
Future Communication

New
Until Help Arrives Would you like to receive additional information about emergency preparedness? Yes
No
If yes, please provide your email address:
Future Communication

New

Sheet 3: PRA Tables

Estimated Annualized Burden Hours and Costs

Type of Respondent Form Name / Form Number No. of Respon-dents No. of Responses per Respon-dent Total No. of Responses Avg. Burden per Response (in hours) Total Annual Burden (in hours) Avg. Hourly Wage Rate Total Annual Respondent Cost

Individuals or Households; Farms; Business or other for-profit; Federal Government; Not-for-profit Institutions; State, local or Tribal Government Preparedness Activity Web Collection / FEMA Form 008-0-8 80,500.00 1.00 80,500.00 0.083 6,708.33 $24.07 $161,469.58
From Form 0134
Same respondents Preparedness Activity Feedback Form , FEMA Form 519-0-11 20,125.00 1 20,125.00 0.083 1,677.08 $24.07 $40,367.40
From Form 0130
Total
$100,625.00
$100,625.00
$8,385.42
$201,836.98












Itemized Changes in Annual Burden Hours



Data Collection Activity/Instrument Program Change (hours currently on OMB Inventory) Program Change (New) Difference Adjustment (hours currently on OMB Inventory) Adjustment (New) Difference



Preparedness Activity Web Collection / FEMA Form 008-0-8 15,000 6,708.33 -8291.67 0 0 0
From Form 0134

Preparedness Activity Feedback Form , FEMA Form 519-0-11 4250 1,677.08 -2572.92 0 0 0
From Form 0130




0

0






0

0






0

0






0

0














Total 19250 8385.41666666667 -10864.5833333333 0 0 0














Itemized Changes in Annual Cost Burden



Data Collection Activity/Instrument Program Change (hours currently on OMB Inventory) Program Change (New) Difference Adjustment (hours currently on OMB Inventory) Adjustment (New) Difference



Preparedness Activity Web Collection / FEMA Form 008-0-8 $547,050.00 $161,469.58 $(385,580.42) $- $- $-
From Form 0134

Preparedness Activity Feedback Form , FEMA Form 519-0-11 $- $40,367.40 $40,367.40 $- $- $-
From Form 0130




$-

$-






$-

$-






$-

$-






$-

$-














Total $547,050.00 $201,836.98 $(345,213.02) $- $- $-



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