Information Collection

All Hazards

IC 272124 under ICR 202505-0920-007 · OMB 0920-0666.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0666 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 57.803 All Hazards	Form and Instruction
Form 57.803 All Hazards All Hazards	Form and Instruction
Form 0920-25-0119 57.803 Daily Facility Operating Status All Hazards	Form
57.803 All Hazards 57.803 All Hazards.docx	Form and Instruction
57.803 All Hazards 57.803 All Hazards.docx	Form and Instruction
0920-25-0119 57.803 Daily Facility Operating Status 57.803 Daily Facility Operating Status-Clean Version.docx	Form
0920-25-0119 57.803 Daily Facility Operating Status 57.803 Daily Facility Operating Status-Clean Version.docx	Form
Change Memo 0920-0666-2.docx Change Request Memo	IC Document
Change Memo 0920-0666-2.docx Change Request Memo	IC Document

IC Title:

All Hazards

Agency IC Tracking Number:

0920-25-0119

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	57.803				Yes	Yes	Fillable Fileable
Form	0920-25-0119				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 540

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	197,100	197,100
Annual IC Time Burden (Hours)	16,425	16,425
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Change Request Memo		05/15/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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