Information Collection

Public Assistance Initial Customer Satisfaction Survey (Internet) (SLTT)

IC 226183 under ICR 202310-1660-003 · OMB 1660-0107.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FF-104-FY-21-156 ( Public Assistance Initial Customer Satisfaction Survey (Internet) (SLTT)	Form
Form FF-104-FY-21-156 ( Public Assistance Initial Customer Satisfaction Survey (Internet) Public Assistance Initial Customer Satisfaction Survey (Internet) (SLTT)	Form
FF-104-FY-21-156 ( Public Assistance Initial Customer Satisfaction Survey ( FF-104-FY-21-156 (formerly 519-0-33) internet.docx	Form
FF-104-FY-21-156 ( Public Assistance Initial Customer Satisfaction Survey ( FF-104-FY-21-156 (formerly 519-0-33) internet.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	FF-104-FY-21-156 (formerly 419-0-33)	Public Assistance Initial Customer Satisfaction Survey (Internet)	FF-104-FY-21-156 (formerly 519-0-33) internet.docx	via email	Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title: Hazard Mitigation, Disaster Public Assistance, and Disaster Loan Programs System of Records

FR Citation: 79 FR 16015

Number of Respondents: 365

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	365	17	348
Annual IC Time Burden (Hours)	30	-16	46
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.