Information Collection Request
Crisis Assistance Request Form - (Dept. of State)
ICR 202306-1405-004 · OMB 1405-0259 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1405-0259 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Crisis Assistance Request Form - (Dept. of State) |
Form and Instruction | New | Available |
 CACMS Privacy Act Statement (002).docx |
Supplementary Document | Uploaded 2023-06-28 | Repair queued |
 30 Day FRN.pdf |
Supplementary Document | Uploaded 2023-06-28 | Repair queued |
| 2022-22211.pdf |
Supplementary Document | Uploaded 2023-06-28 | Repair queued |
| Crisis Form - Legal Authorities (2-28-22) - Copy.docx |
Supplementary Document | Uploaded 2023-06-28 | Available |
| Supporting Statement - Generic Online form (final) (28-jun) (004).docx |
Supporting Statement A | Uploaded 2023-06-28 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 261711 |  Crisis Assistance Request Form - (Dept. of State) |
Form and Instruction | New |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | STATE/AFA |
| OMB Control No | 1405-0259 |
| Type of Information Collection | New collection (Request for a new OMB Control Number) |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |