TCP Disaster TA Intake Form

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Documents and Forms

Document Name Document Type
TCP Disaster TA Intake Form Form and Instruction
Thriving Communities Program Disaster Intake Form FY 2025 Thriving Communities Program Disaster Intake Form_02-25-2025.docx Form and Instruction
Generic Clearance.SubmissionTemplate_PRA112124.docx Generic Template IC Document

Information Collection (IC) Details

IC Title:	TCP Disaster TA Intake Form	Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Thriving Communities Program Disaster Intake Form	FY 2025 Thriving Communities Program Disaster Intake Form_02-25-2025.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Template	Generic Clearance.SubmissionTemplate_PRA112124.docx	11/22/2024

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