Debt Collection Financial Statement

Forms and Documents

Document Name	Status
Form FEMA Form FF-600-F Debt Collection Financial Statement Form	Modified
1660-0011 Supporting Statement A 04 30 2025.docx Supporting Statement A	2025-05-01
Public Law 104-134, CHAPTER 10 DEBT COLLECTION IMPROVEMENTS.pdf Supplementary Document	2017-08-08
31 CFR Parts 900 - 904.pdf Supplementary Document	2014-05-13
31 USC 3701.pdf Supplementary Document	2014-05-13
1660-0011 - Published 30-Day Extension FRN - 2025 04 30.pdf Supplementary Document	2025-05-01
6 CFR Part 11, eCFR — Code of Federal Regulations.mht Supplementary Document	2014-05-13
1660-0011 - Published 60-Day Extention FRN - 2025 01 16.pdf Supplementary Document	2025-03-07
Title 31 Sec 3711.pdf Supplementary Document	2008-01-16

IC Document Collections

IC ID	Document Title	Status
21056	Debt Collection Financial Statement Form	Modified

ICR Details

OMB Control No: 1660-0011	ICR Reference No: 202503-1660-001
Status: Received in OIRA	Previous ICR Reference No: 202006-1660-009
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: Debt Collection Financial Statement
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 05/20/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	06/30/2025
Responses	140	300
Time Burden (Hours)	105	225
Cost Burden (Dollars)	0	0

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Abstract: FEMA Form FF-600-FY-22-102 (formerly 127-0-1) is used to collect information provided voluntarily by the debtor to evaluate the debtor’s financial abilities to determine if they qualify for a payment plan and set repayment terms, or determine a compromise to write-off a debt in part or in full. Financial information obtained is essential to evaluate the debtor’s ability for the payment of the debt in part or in full. Debt may be a recoupment of an ineligible disaster assistance payment or improper payment to an employee.

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Authorizing Statute(s): US Code: 31 USC 3701 Name of Law: Definitions and Applications
   US Code: 31 USC 3711 Name of Law: Collection and Compromise
  

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:
	90 FR 4759	01/16/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 17847	04/30/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Debt Collection Financial Statement	FEMA Form FF-600-FY-22-102 (formerly 127-0-1)	Debt Collection Financial Statement

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ICR Summary of Burden

	Total Request	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	140	300	0	0	-160	0
Annual Time Burden (Hours)	105	225	0	0	-120	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: There is a decrease in the burden hours due to a decrease in the number of respondents. The overall decrease in annual costs is due to the decrease in the number of respondents.

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Annual Cost to Federal Government: $23,877

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.     Yes

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: 05/20/2025

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