Information Collection

FEMA Congressional Mental Health Emergency Manager Wellness Study Survey

IC 263972 under ICR 202312-1660-003 · OMB 1660-0168.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FF-119-FY-23-100 FEMA Congressional Mental Health Emergency Manager Wellness Study Survey	Form and Instruction
FF-119-FY-23-100 FEMA Congressional Mental Health Emergency Manager Welln FF-119-FY-23-100.docx	Form and Instruction
FF-119-FY-23-100 FEMA Congressional Mental Health Emergency Manager Welln FF-119-FY-23-100.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

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	FF-119-FY-23-100	FEMA Congressional Mental Health Emergency Manager Wellness Study Survey	FF-119-FY-23-100.docx		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: 378

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	378	378
Annual IC Time Burden (Hours)	189	189
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.