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Federal forms, ICRs, and supporting documents

Information Collection

Disaster Human Services Case Management Intake Assessment – Survivor

IC 262629 under ICR 202502-0970-023 · OMB 0970-0619.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Disaster Human Services Case Management Intake Assessment – Survivor
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Disaster Human Services Case Management Intake Assessment Form ACF OHSEPR Disaster Human Services Case Management Intake Assessment Form 2025 - CLEAN.docx Yes Yes Fillable Fileable

Community and Social Services Social Services

OHESPR Repatriation and Disaster Human Services Case Management Records  88 FR 63109

9,000 0
   
Individuals or Households
 
   95 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 9,000 0 0 0 0 9,000
Annual IC Time Burden (Hours) 13,500 0 0 0 0 13,500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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