Assessment Survey - Phone

Federal Emergency Management Agency Individual Assistance Customer Satisfaction Surveys

Documents and Forms

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

Information Collection (IC) Details

IC Title:	Assessment Survey - Phone	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:

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 %

	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

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.