Application for Community Disaster Loan (CDL) Program

Forms and Documents

Document Name	Status
Form FEMA Form 116-0-1c Government of Virgin Island - Promissory Note Form and Instruction	Modified
Form FEMA Form 116-0-1b RLS Hospital and Medical Center Form and Instruction	Modified
Form FEMA Form 116-0-1a JFL Hospital and Medical Center Form and Instruction	Modified
Form FEMA Form 112-0-3C CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION Form	Modified
Form FEMA Form 090-0-1 Certification of Eligibility for Community Disaster Loans Form	Modified
Form FEMA Form 085-0-1 Local Government Resolution –Collateral Security Form	Modified
Form FEMA Form 116-0-1 Promissory Note Form	Modified
Published 60 Day FRN.pdf Supplementary Document	2018-08-31
Supporting Statement A 1660-0083 Part A Final.docx Supporting Statement A	2018-10-25
SF-1199A.pdf Supplementary Document	2015-07-27
SORN, DHS-FEMA, 009-Hazard Mitigation, Disaster Public Assistance, and Disaster Loan Programs.pdf Supplementary Document	2015-06-25
Privacy PIA_pia_fema_grants_management.pdf Supplementary Document	2015-06-25
Stafford Act Booklet 042213.pdf Supplementary Document	2015-06-25
Stafford Act Booklet 042213, (Sec 417).pdf Supplementary Document	2015-06-25
44 CFR Part 206, Subpart K—Community Disaster Loans.pdf Supplementary Document	2015-06-25
42 U.S.C. Sec 5184.pdf Supplementary Document	2015-06-25

IC Document Collections

IC ID	Document Title	Status
229521	Government of Virgin Island - Promissory Note Form and Instruction	Modified
229520	RLS Hospital and Medical Center Form and Instruction	Modified
229519	JFL Hospital and Medical Center Form and Instruction	Modified
228942	CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION Form	Modified
21182	Certification of Eligibility for Community Disaster Loans Form	Modified
189000	Letter of Application	Modified
188997	Local Government Resolution –Collateral Security Form	Modified
188996	Promissory Note Form	Modified

ICR Details

OMB Control No: 1660-0083	ICR Reference No: 201808-1660-004
Status: Historical Active	Previous ICR Reference No: 201803-1660-001
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: Application for Community Disaster Loan (CDL) Program
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/25/2018
	Date Received in OIRA: 08/31/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2021	36 Months From Approved	10/31/2018
Responses	144	0	259
Time Burden (Hours)	518	0	905
Cost Burden (Dollars)	0	0	0

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Abstract: The Loan Package for the Community Disaster Loan Program provides States, Local and Tribal governments that have suffered substantial loss of tax or other revenues as a result of a major disaster or emergency, the opportunity to obtain financial assistance in order to perform their governmental functions. Local governments can submit a loan package for the Community Disaster Loan Program. This loan must be justified on the basis of need and actual expenses.

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Authorizing Statute(s): US Code: 42 USC 5184 Name of Law: Community Disaster Loans
  

Citations for New Statutory Requirements: None

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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:
	83 FR 30759	06/29/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 30759	08/31/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 8

IC Title	Form No.	Form Name
Certification of Eligibility for Community Disaster Loans	FEMA Form 090-0-1	CERTIFICATION OF ELIGIBILTY FOR COMMUNITY DISASTER LOANS
Promissory Note	FEMA Form 116-0-1	PROMISSARY NOTE
Letter of Application
Local Government Resolution –Collateral Security	FEMA Form 085-0-1	LOCAL GOVERNMENT RESOLUTION - COLLATERAL SECURITY
CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION	FEMA Form 112-0-3C	CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION
JFL Hospital and Medical Center	FEMA Form 116-0-1a	JFL Hospital and Medical Center - Promissary Note
RLS Hospital and Medical Center	FEMA Form 116-0-1b	RLS Hospital and Medical Center
Government of Virgin Island - Promissory Note	FEMA Form 116-0-1c	Government of US Virgin Island Promissary Note

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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	144	259	0	0	-115	0
Annual Time Burden (Hours)	518	905	0	0	-387	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: Burden hours were estimated based upon historical experience dating back a decade or more as well as recent experience implementing the program. The changes depict a more accurate reflection of the program. There is no change to the information being collected.

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Annual Cost to Federal Government: $1,012,699

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.     Yes

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: 08/31/2018

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