Information Collection

Appendix I Questionnaire - Individuals or Households

IC 251391 under ICR 202601-0596-001 · OMB 0596-0246.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Questionnaire Appendix I Questionnaire - Individuals or Households	Form and Instruction
Form Questionnaire 0596-0246 Appendix I Questionnaire ENGLISH Appendix I Questionnaire - Individuals or Households	Form and Instruction
Form Questionnaire 0596-0246 Appendix I Questionnaire SPANISH Appendix I Questionnaire - Individuals or Households	Form and Instruction
Questionnaire 0596-0246 Appendix I Questionnaire ENGLISH 0596-0246 Appendix I Questionnaire.docx	Form and Instruction
Questionnaire 0596-0246 Appendix I Questionnaire ENGLISH 0596-0246 Appendix I Questionnaire.docx	Form and Instruction
Questionnaire 0596-0246 Appendix I Questionnaire SPANISH 0596-0246 Appendix I Questionnaire SPANISH.docx	Form and Instruction
Questionnaire 0596-0246 Appendix I Questionnaire SPANISH 0596-0246 Appendix I Questionnaire SPANISH.docx	Form and Instruction

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 and Instruction	Questionnaire				No		Paper Only
Form and Instruction	Questionnaire				No		Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 75

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	75	-325	400
Annual IC Time Burden (Hours)	44	-87	131
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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].