Information Collection

PHEM Tool

IC 262113 under ICR 202309-0920-004 · OMB 0920-1417.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1417 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PHEM Tool	Form and Instruction
PHEM Tool Att3 -PHEM Tool_final.xlsx	Form and Instruction
PHEM Tool Att3 -PHEM Tool_final.xlsx	Form and Instruction

IC Title:

PHEM Tool

Agency IC Tracking Number:

0920-23EH

Is this a Common Form? No

IC Status: New

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 and Instruction	n/a	PHEM Tool	Att3 -PHEM Tool_final.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	72	72
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.