Information Collection

Assessment Survey - Phone

IC 226848 under ICR 202305-1660-006 · OMB 1660-0143.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FEMA Form FF-104-F Assessment Survey - Phone	Form and Instruction
FEMA Form FF-104-F Assessment Survey (Phone Survey) FEMA Form FF-104-FY-21-163 (formerly 519-0-40) Assessment Survey-Phone.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 44 CFR 206.101

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 and Instruction	FEMA Form FF-104-FY-21-163 (formerly 519-0-40)	Assessment Survey (Phone Survey)	FEMA Form FF-104-FY-21-163 (formerly 519-0-40) Assessment Survey-Phone.docx		Yes	No	Fillable Fileable Signable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,744

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,744	-1,824	5,568
Annual IC Time Burden (Hours)	749	-365	1,114
Annual IC Cost Burden (Dollars)	0	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.