Information Collection

Debt Collection Financial Statement

IC 21056 under ICR 202503-1660-001 · OMB 1660-0011.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FEMA Form FF-600-F Debt Collection Financial Statement	Form
Form FEMA Form FF-600-F Debt Collection Financial Statement Debt Collection Financial Statement	Form
FEMA Form FF-600-F Debt Collection Financial Statement DCFS_FF-600-FY-22-102 (formerly 127-0-1).pdf	Form
FEMA Form FF-600-F Debt Collection Financial Statement DCFS_FF-600-FY-22-102 (formerly 127-0-1).pdf	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	FEMA Form FF-600-FY-22-102 (formerly 127-0-1)				Yes	No	Printable Only

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records

Title: DHS/ALL-008 â Accounts Receivable System of Records

FR Citation: 80 FR 65176

Number of Respondents: 140

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	140	-160	300
Annual IC Time Burden (Hours)	105	-120	225
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.

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