Immediate Disaster Case Management Intake Assessment

Documents and Forms

Document Name Document Type
ECMRS Paper Forms 20181227 new PRA Statement.docx Other-Multiple Forms

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Immediate Disaster Case Management Intake Assessment	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 44 CFR Chapter I, Subchapter D 44 CFR 206.8 44 CFR 206.208(c)(2) 6 CFR 5 44 CFR 206.191 44 CFR 206.64 44 CFR 206.113 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Multiple Forms			ECMRS Paper Forms 20181227 new PRA Statement.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 33,489	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	11,163	-618,837	630,000
Annual IC Time Burden (Hours)	11,163	-618,837	630,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.