Federal Hotel and Motel Fire Safety Declaration Form

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FF-USFA-FY-21-112 Federal Hotel and Motel Fire Safety Declaration Form	Form and Instruction	Modified	Repair queued
Form FF-USFA-FY-21-112 Federal Hotel and Motel Fire Safety Declaration Form	Form and Instruction	Modified	Available
Form FF-USFA-FY-21-112 Federal Hotel and Motel Fire Safety Declaration Form (Review of Form)	Form and Instruction	Modified	Repair queued
Form FF-USFA-FY-21-112 Federal Hotel and Motel Fire Safety Declaration Form	Form and Instruction	Modified	Available
1660-0068 - Published 30-Day Extension FRN - 2025 03 27.pdf	Supplementary Document	Uploaded 2025-03-27	Repair queued
1660-0068 - Published 30-Day Extension FRN - 2025 03 27.pdf	Supplementary Document	Uploaded 2025-03-27	Available
1660-0068 - Published 60-Day Extension FRN - 2024 12 11.pdf	Supplementary Document	Uploaded 2024-12-12	Repair queued
1660-0068 - Published 60-Day Extension FRN - 2024 12 11.pdf	Supplementary Document	Uploaded 2024-12-12	Missing upstream
1660-0068 - Supporting Statement A - 2025 03 27 clean.docx	Supporting Statement A	Uploaded 2025-03-27	Repair queued
1660-0068 - Supporting Statement A - 2025 03 27 clean.docx	Supporting Statement A	Uploaded 2025-03-27	Repair queued
Title 15 2224.pdf	Supplementary Document	Uploaded 2015-04-21	Repair queued
Title 15 2224.pdf	Supplementary Document	Uploaded 2015-04-21	Repair queued
Public Law 101-391.pdf	Supplementary Document	Uploaded 2009-02-27	Repair queued
Public Law 101-391.pdf	Supplementary Document	Uploaded 2009-02-27	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
21152	Federal Hotel and Motel Fire Safety Declaration Form	Form and Instruction	Modified	Federal Hotel and Motel Fire Safety Declaration Form
21152	Federal Hotel and Motel Fire Safety Declaration Form	Form and Instruction	Modified
188195	Federal Hotel and Motel Fire Safety Declaration Form	Form and Instruction	Modified	Federal Hotel and Motel Fire Safety Declaration Form (Review of Form)
188195	Federal Hotel and Motel Fire Safety Declaration Form	Form and Instruction	Modified

ICR Details

OMB Control No: 1660-0068	ICR Reference No: 202412-1660-001
Status: Active	Previous ICR Reference No: 202110-1660-001
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: Federal Hotel and Motel Fire Safety Declaration Form
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/18/2026
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/27/2025
Terms of Clearance: The collection is approved for three years. The agency shall add the non-complaint reporting form to this collection or terminate it within 9 months of this clearance.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2029	36 Months From Approved	05/31/2026
Responses	2,630	0	3,141
Time Burden (Hours)	710	0	836
Cost Burden (Dollars)	0	0	0

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Abstract: The Federal Hotel and Motel Fire Safety Declaration Form, FEMA Form FF-USFA-FY-21-112 (formerly 516-0-1), is used to collect basic information on life-safety systems related directly to fire-safety in hotels, motels, and similar places of accommodation applying for inclusion on the NML. In completing the form, applicants—property owners, lodging managers, or their delegates—provide basic information including identification of the owner(s) of the property, the business’s Employer Identification Number (EIN), and provisions for life-safety from fire. The form requests specific responses from applicants as to the installation of smoke alarms in all guestrooms of properties submitted for listing on the NML. In addition, applicants must indicate if the lodging establishment has an automatic fire sprinkler system where the building is four stories or higher. Once approved for the NML, the database record for each lodging establishment is assigned a unique identification number (FEMA ID). The information is collected and distributed through an on-line, electronic database accessed through the USFA website. Information submitted voluntarily by lodging establishments is reviewed and if the criteria meet the requirements of Public Law 101-391, they are given a FEMA ID number and listed in the NML database. Federal travelers and the public seeking public accommodation with provisions for life-safety from fire access the NML through the on-line database and identify lodging establishments in the area to which they are traveling.

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Authorizing Statute(s): PL: Pub.L. 101 - 391 3 Name of Law: Hotel and Motel Fire Safety Act of 1990
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 99889	12/11/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 13868	03/27/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Federal Hotel and Motel Fire Safety Declaration Form	FF-USFA-FY-21-112 (formerly 516-0-1)	Federal Hotel and Motel Fire Safety Declaration Form (Review of Form)
Federal Hotel and Motel Fire Safety Declaration Form	FF-USFA-FY-21-112 (formerly 516-0-1)	Federal Hotel and Motel Fire Safety Declaration Form

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,630	3,141	0	0	-511	0
Annual Time Burden (Hours)	710	836	0	0	-126	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The burden hours have decreased based on the reduced estimated number of respondents and responses mitigated by a slight increase in the average time per response for state review from 0.33 burden hours to 0.3333 burden hours. The current annual hour burden is 836 hours, the new hours burden is 710 for a decrease of 126 annual burden hours. The annual cost burden for this collection is reduced by the reduction of 126 burden hours, mitigated by the increase in wage rates for an overall net increase of $1,314.

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Annual Cost to Federal Government: $104,267

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/27/2025

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