Federal Emergency Management Agency Individual Assistance Customer Satisfaction Surveys

Forms and Documents

Document Name	Status
Form FEMA Form 519-0-41 Assessment Survey (Electronic) Form and Instruction	New
Form FEMA Form 519-0-40 Assessment Survey (Phone Survey) Form and Instruction	New
Form FEMA Form 519-0-39 Contact Survey (Electronic) Form and Instruction	New
Form FEMA Form 519-0-38 Contact Survey (Phone Survey) Form and Instruction	New
Form FEMA Form 519-0-37 Initial Survey Electronic Form and Instruction	New
Form FEMA Form 519-0-36 Initial Survey (Phone) Form and Instruction	New
Sandy Recovery Improvement Act of 2013 P.L. 113-2.pdf Supplementary Document	2017-05-17
Memorandum of March 1995, Improving Customer Service .pdf Supplementary Document	2017-05-17
GPRA Modernization Act 2010 1-5-2010.pdf Supplementary Document	2017-05-17
GPRA 1993 PL103_62.pdf Supplementary Document	2017-05-17
FEMA 44 CFR 206.101-IA-IHP.pdf Supplementary Document	2017-05-17
Executive Order 13571 April 27, 2011.pdf Supplementary Document	2017-05-17
Executive Order 13411 2006.pdf Supplementary Document	2017-05-17
Executive Order 12862.pdf Supplementary Document	2017-05-17
E-Government 2002.pdf Supplementary Document	2017-05-17
1660-NEW OMB 83I Attachment.docx Supplementary Document	2017-05-17
1660-NEW OMB83I Individual Assistance Surveys. .pdf Supplementary Document	2017-05-17
SORN-DHS 008 Disaster Recovery Assistance Files System of Records 4-30-2013.pdf Supplementary Document	2017-05-17
Published 60 Day FRN .pdf Supplementary Document	2017-05-17
Published 30 Day FRN.pdf Supplementary Document	2017-05-17
Supporting Statement Part B 1660-NW102.docx Supporting Statement B	2017-05-16
Supporting Statement Part A 1660-NW102 FEMA V09182017.docx Supporting Statement A	2017-09-20

IC Document Collections

IC ID	Document Title	Status
226885	On-Line interviews	New
226884	One-on-One Interviews	New
226883	Focus Group for 2 Hrs. Plus Travel 1 Hr.	New
226850	Assessment Survey (Electronic) Form and Instruction	New
226848	Assessment Survey (Phone Survey) Form and Instruction	New
226847	Contact Survey (Electronic) Form and Instruction	New
226843	Contact Survey (Phone Survey) Form and Instruction	New
226842	Initial Survey Electronic Form and Instruction	New
226811	Initial Survey (Phone) Form and Instruction	New

ICR Details

OMB Control No: 1660-0143	ICR Reference No: 201705-1660-004
Status: Active	Previous ICR Reference No:
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: Federal Emergency Management Agency Individual Assistance Customer Satisfaction Surveys
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/26/2017
	Date Received in OIRA: 08/01/2017
Terms of Clearance: Agency clarified its methodology and how it proposed to use the information. .

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2020	36 Months From Approved
Responses	24,096	0	0
Time Burden (Hours)	8,095	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Federal agencies are required to survey their customers to determine the kind and quality of services customers want and their level of satisfaction with those services. Analysis from the survey is used to measure FEMA's survivor-centric mission of being accessible, simple, timely and effective in meeting the needs of survivors.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: EO: EO 13571 Name/Subject of EO: Streamlining Service Delivery and Improving Customer Service
EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 8836	01/31/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 17672	04/12/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 9

IC Title	Form No.	Form Name
Contact Survey (Electronic)	FEMA Form 519-0-39	Contact Survey (Electronic)
Assessment Survey (Phone Survey)	FEMA Form 519-0-40	Assessment Survey (Phone Survey)
Initial Survey Electronic	FEMA Form 519-0-37	Initial Survey (Electronic)
Contact Survey (Phone Survey)	FEMA Form 519-0-38	Contact Survey (Phone Survey)
Assessment Survey (Electronic)	FEMA Form 519-0-41	Assessment Survey (Electronic)
Initial Survey (Phone)	FEMA Form 519-0-36	Initial Survey (Phone Survey)
One-on-One Interviews
Focus Group for 2 Hrs. Plus Travel 1 Hr.
On-Line interviews

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	24,096	0	0	24,096	0	0
Annual Time Burden (Hours)	8,095	0	0	8,095	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The survey results serve as a vital tool for measuring customer satisfaction and are a requirement of the Executive Orders 12682 and 13571, and resulting Memorandums for “Streamlining Service Delivery and Improving Customer Service.” The surveys also measure the effectiveness of the Administrator’s Strategic Plan based on the disaster survivor’s perspective. If conducted less frequently, it would result in an unrepresentative estimate of customer satisfaction and distort overall views of the performance of the program.

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Annual Cost to Federal Government: $1,766,288

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/01/2017

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