Form FEMA Form FF-008-F FEMA Form FF-008-F Preparedness Activity Feedback Form

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Overview

Rollup
Question Bank
PRA Tables

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Sheet 1: Rollup

Category	Initiative	Count of Question
Activity Details		61
	AP Satisfaction	29
	Create Activity	16
	Ready 2 Help	5
	Until Help Arrives	7
	Materials Ordering	3
	CBO Training	1
Feedback		34
	AP Satisfaction	18
	Until Help Arrives	6
	Experience	10
Future Communication		3
	Ready 2 Help	1
	Until Help Arrives	2
Information Text		5
	AP Satisfaction	2
	Materials Ordering	3
POC Information		27
	Create Account	14
	Create Activity	4
	Materials Ordering	9
Order Form		3
	Materials Ordering	3
Course Feedback		8
	CBO Training	8
Material Download		7
	CBO Training	7
Total Result		148

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Sheet 2: Question Bank

Initiative	Question	Response	Category	Sub Category	Notes	112-2-1 Reference
AP Satisfaction	Did you complete a preparedness action as part of America's PrepareAthon!?	Yes No (Skip to question 12)	Activity Details			Existing - Not Used
AP Satisfaction	On which hazard(s) did you focus your Day of Action?	Tornado Flood Hurricane Wildfire Earthquake Hazardous material release Winter weather / Ice storm Extreme heat Other	Activity Details	Content		Existing - Not Used
AP Satisfaction	What activities did you do? (check all that apply)	Found out what disasters might happen in my community Learned about and signed up for local alerts and warnings Learned what to do to protect yourself for the hazards in my community Developed, updated, or practiced your family/household communications plan Collected and updated critical documents you might need Collected, updated, refreshed your emergency tools and supplies Signed up to take training in first aid, CPR, AED, CERT Planned, reviewed, and practiced your evacuation route and transportation plans Identified and practiced taking shelter in a protective location Took steps to protect your home and personal property Met with friends and family to discuss preparing Other	Activity Details	Content		Existing - Not Used
AP Satisfaction	How many adults in your household participated in the activity?		Activity Details	Number Participants		Existing - Not Used
AP Satisfaction	How many youth in your household participated in the activity?		Activity Details	Number Participants		Existing - Not Used
AP Satisfaction	Did you do more, less, or what you indicated you would do in your registration?	More Less Same	Activity Details	Content		Existing - Not Used
AP Satisfaction	Which America's PrepareAthon! resources did you use to plan and conduct your Day of Action? (check all that apply)	America's PrepareAthon! preparedness materials: How to Prepare Guide Individual and Family Playbook Resource Guide for Alerts and Warnings Other materials	Activity Details	Other		Existing - Not Used
AP Satisfaction	Have you visited the National Preparedness Community discussion boards since you registered to participate in America's PrepareAthon?	Yes No I don't know	Activity Details	Other		Existing - Not Used
AP Satisfaction	Did you participate in any social media related to America's PrepareAthon?	Yes No	Activity Details	Other		Existing - Not Used
AP Satisfaction	In what state are you located?		Activity Details	Location		Existing - Not Used
AP Satisfaction	In what zip code are you located?		Activity Details	Location		Existing - Not Used
AP Satisfaction	Please select the category that best describes your organization from the following list:	Access/Functional/Disability Needs Organizations Medical Reserve Corps Animal Shelter/Service Providers Businesses/Industry Associations Media Organizations Military Museums/Libraries/Parks etc. Non-profit Organizations Pets/Livestock/Agriculture Preparedness Organizations Red Cross Chapter Science/engineering organizations Scouting Groups Senior Facilities/Communities State Government Tribes/Tribal Leadership Youth Organizations VOAD (Voluntary Organizations Active in Disasters) Volunteer Radio Clubs Volunteer Organizations/Service Clubs Other CERT Groups Childcare and Preschool Citizen Corps Council Colleges/Universities Communication Groups Congressional Faith-based Organizations Federal Government Fire/Emergency Responders Healthcare HOA/Neighborhood Groups Individuals/Families K-12 Schools and Districts Local Government Media Organizations	Activity Details	Audience Type		Existing - Not Used
AP Satisfaction	[K-12 Schools and Districts Only] Which best describes your school?	Public Private Other (Please specify)	Activity Details	Audience Type		Existing - Not Used
AP Satisfaction	[Volunteer Organizations Only] Which level do you represent?	Chapter/Local Headquarters/National Not applicable Other	Activity Details	Audience Type		Existing - Not Used
AP Satisfaction	[Private Sector Only] How many employees does your business have?	1 - 99 100 - 499 500 - 1,499 1500 - 4,999 5,000 - or more	Activity Details	Number Participants		Existing - Not Used
AP Satisfaction	In addition to registering your participation, which of the following did the America's PrepareAthon! website, www.ready.gov/prepare help you to do? (select all that apply)	Download/print resources Learn about hazards in my area Learn what I should do to prepare Download/print resources Learn about preparedness activities in my state/community Learn about the organizations supporting America's PrepareAthon! Learn about research in emergency preparedness Share my participation in America's PrepareAthon! with others Print a certificate of participation Other (please specify) I did not use the America's PrepareAthon! website	Activity Details	Resources		Existing - Not Used
AP Satisfaction	Did you complete a preparedness action as part of America's PrepareAthon!?	Yes No (Skip to Question 13)	Activity Details	Other		Existing - Not Used
AP Satisfaction	On which hazard(s) did you focus your Day of Action?	Tornado Flood Hurricane Wildfire Earthquake Hazardous material release Winter weather / Ice storm Extreme heat Other	Activity Details	Hazards		Existing - Not Used
AP Satisfaction	What activities did you conduct? (check all that apply)	Conducted a tabletop exercise to test your organizational readiness (e.g. emergency response plans, continuity plans, communications systems) Conducted training for people in your organization to support organizational preparedness and response Conducted an educational discussion for the people in your organization for their personal and household preparedness Conducted a drill for the people in your organization for their personal and household preparedness Conducted a training for the people in your organization for their personal and household preparedness Other	Activity Details	Content		Existing - Not Used
AP Satisfaction	How many adults in your organization participated in the activity?		Activity Details	Number Participants		Existing - Not Used
AP Satisfaction	How many youth in your organization participated in the activity?		Activity Details	Number Participants		Existing - Not Used
AP Satisfaction	Did your organization do more, less, or what you indicated you would do in your registration?	I don't know Same Less More	Activity Details	Content		Existing - Not Used
AP Satisfaction	Which America's PrepareAthon! resources did you use to plan and conduct your Day of Action? (check all that apply)	America's PrepareAthon! preparedness materials: How to Prepare Guide Playbook Day of Action Guide: Prepare Your People Day of Action Guide: Prepare Your Organization Resource Guide for Alerts and Warnings Other	Activity Details	Resources		Existing - Not Used
AP Satisfaction	Have you visited the National Preparedness Community discussion boards since you registered to participate in America's PrepareAthon?	Yes No I don't know	Activity Details	Resources		Existing - Not Used
AP Satisfaction	Did you participate in any social media related to America's PrepareAthon?	Yes No	Activity Details	Other		Existing - Not Used
AP Satisfaction	Which America's PrepareAthon promotional materials did you use? (check all that apply)	Posters Web banners Digital invites None	Activity Details	Resources		Existing - Not Used
AP Satisfaction	Did you customize any of these materials?	Yes No	Activity Details	Resources		Existing - Not Used
AP Satisfaction	In what state is your organization located?		Activity Details	Location		Existing - Not Used
AP Satisfaction	In what zip code is your organization located?		Activity Details	Location		Existing - Not Used
AP Satisfaction	In addition to registering your participation, which of the following did the America's PrepareAthon! website, www.ready.gov/ prepare help you to do? (select all that apply)	Learn about hazards in my area Learn what I should do to prepare Download/print resources Learn about preparedness activities in my state/community Learn about the organizations supporting America's PrepareAthon! Learn about research in emergency preparedness Share my participation in America's PrepareAthon! with others Print a certificate of participation Other (please specify) I did not use the America's PrepareAthon! website	Feedback			Existing - Not Used
AP Satisfaction	How satisfied were you with your ability to find what you were looking for?	Very satisfied Satisfied Neither satisfied nor dissatisfied Dissatisfied Not applicable	Feedback			Existing - Not Used
AP Satisfaction	[If “Dissatisfied” or “Very dissatisfied”] What would have made it easier to find what you were looking for? [open-ended]	Free Text	Feedback			Existing - Not Used
AP Satisfaction	How helpful were these materials for planning and conducting your Day of Action?	Extremely helpful Very helpful Somewhat helpful A little helpful Not at all helpful	Feedback			Existing - Not Used
AP Satisfaction	How satisfied are you with how easy it was to get involved in America's PrepareAthon?	Very satisfied Satisfied Neither satisfied nor dissatisfied Dissatisfied Very dissatisfied	Feedback			Existing - Not Used
AP Satisfaction	Are you more prepared as a result of participating in America's PrepareAthon?	A great deal more prepared Somewhat more prepared No change to my level of preparedness I am more confused about how to prepare Not sure	Feedback			Existing - Not Used
AP Satisfaction	Do you plan to participate in the next America's PrepareAthon?	Yes No Not sure	Feedback			Existing - Not Used
AP Satisfaction	Would you encourage others to participate?	Yes No	Feedback			Existing - Not Used
AP Satisfaction	What suggestions do you have for the next America's PrepareAthon?	Free Text	Feedback			Existing - Not Used
AP Satisfaction	How satisfied were you with your ability to find what you were looking for?	Very satisfied Satisfied Neither satisfied nor dissatisfied Dissatisfied Very dissatisfied Not applicable	Feedback			Existing - Not Used
AP Satisfaction	[If “Dissatisfied” or “Very dissatisfied”] What would have made it easier to find what you were looking for?	Free Text	Feedback			Existing - Not Used
AP Satisfaction	How helpful were these materials for planning and conducting your Day of Action?	Not at all helpful A little helpful Somewhat helpful Very helpful Extremely helpful	Feedback			Existing - Not Used
AP Satisfaction	[If yes] How easy was it to customize?	Very easy Easy Neither easy nor difficult Difficult Very difficult	Feedback			Existing - Not Used
AP Satisfaction	How satisfied are you with how easy it was to get involved in America's PrepareAthon?	Very satisfied Satisfied Neither satisfied nor dissatisfied Dissatisfied Very dissatisfied	Feedback			Existing - Not Used
AP Satisfaction	Are you more prepared as a result of participating in America's PrepareAthon?	A great deal more prepared Somewhat more prepared No change to my level of preparedness I am more confused about how to prepare Not sure	Feedback			Existing - Not Used
AP Satisfaction	Do you plan to participate in the next America's PrepareAthon?	Yes No Not sure	Feedback			Existing - Not Used
AP Satisfaction	Would you encourage others to participate?	Yes No	Feedback			Existing - Not Used
AP Satisfaction	What suggestions do you have for the next America's PrepareAthon?		Feedback			Existing - Not Used
AP Satisfaction	Thank you very much for your time! We appreciate your willingness to provide feedback to help make the next America's PrepareAthon! an even greater success. Congratulations on doing your part to be prepared!		Information Text			Existing - Not Used
AP Satisfaction	Thank you for registering to participate in America's PrepareAthon! Because you registered to participate we are contacting you to complete this survey. This survey is intended to help us assess and improve the usefulness of America's PrepareAthon! website, guides and other resources. This survey is voluntary and anonymous; your answers will not be linked to your name or email address. The IP address for the computer you use will be collected with your answers, but this information will be deleted later to protect your privacy. This survey will be closed on [Month, Day]. Please complete it before that date. You may quit the survey at any time by clicking “Exit this Survey.” You can stop and return later on the same computer to change or complete your entries, up until [Month, Day]. The survey should take about 10 minutes. You must be at least 18 years old to participate. If you have any questions or comments about this survey, please contact FEMA-prepare@fema.dhs.gov.		Information Text			Existing - Not Used
CBO Training	Number of represented organizations	1-4 5-9 10-14 15+	Activity Details	Number Participants		New
CBO Training	How many times will you teach this course?	1 2-3 4-5 6+	Material Download	Frequency		New
CBO Training	Estimated number of learners per course?	1-10 11-20 21-30 30-40 40+	Material Download	Number Participants		New
CBO Training	Zip code of delivery? Please, enter zip code of first delivery if offering more than one	Free Text	Material Download	Location		New
CBO Training	Audience type? (select all that apply)	Service Organization (i.e. food bank; soup kitchen, goods donation) Faith-Based Organization; school; child aftercare facility; assisted living center Business Other (with free text)	Material Download	Audience Type		New
CBO Training	Age range of learners? (select all that apply)	Under 12 12-18 18-30 30-50 50+	Material Download	Age		New
CBO Training	Which modules do you plan to teach? (select all that apply)	Modules TBD; may be up to ten modules so this would be modules 1-10	Material Download	Content		New
CBO Training	Would you like to receive additional information about emergency preparedness?	Yes No If yes, please provide your email address:	Material Download			New
CBO Training	This course taught me valuable concepts.	Strongly Disagree Disagree Neutral Agree Strongly Agree Please provide additional comments below.	Course Feedback	Feedback		New
CBO Training	After taking this course, I am more likely to take steps to prepare my community based organization for emergencies and disasters	Agree Disagree	Course Feedback			New
CBO Training	Which modules did you complete? (select all that apply)	Modules TBD; may be up to ten modules so this would be modules 1-10	Course Feedback			New
CBO Training	What could make this course better?	Free Text	Course Feedback			New
CBO Training	Why did you take this course? (select all that apply)	To fulfill a requirement To broaden my understanding and awareness To improve my organization's response in an emergency situation To increase my level of comfort in continuing service during an emergency	Course Feedback			New
CBO Training	How did you hear about this course? (select all that apply)	Internet search Word of mouth Advertisement Social Media Other	Course Feedback			New
CBO Training	Would you like to receive additional information about emergency preparedness?	Yes No If yes, please provide your email address:	Course Feedback			New
CBO Training	How do you want your name to appear on your certificate?	Free Text	Course Feedback			New
Create Account	Username/Email Address	Free Text	POC Information			Existing - In use
Create Account	Confirm Email Address	Free Text	POC Information			Existing - In use
Create Account	Password	Free Text	POC Information			Existing - In use
Create Account	Confirm Password	Free Text	POC Information			Existing - In use
Create Account	First Name	Free Text	POC Information			Existing - In use
Create Account	Last Name	Free Text	POC Information			Existing - In use
Create Account	Organization Name	Free Text	POC Information			Existing - In use
Create Account	City	Free Text	POC Information			Existing - In use
Create Account	Country	Select	POC Information			Existing - In use
Create Account	State	Select	POC Information			Existing - In use
Create Account	I would like my name/organization to appear on the FEMA Preparedness Portal website as a supporter.	Yes No	POC Information			Existing - In use
Create Account	I affirm that I meet the age requirements for joining and am 18 years of age or older, or I am a parent/guardian/sponsor registering on behalf of a minor under 18 years of age. I have read and accept the site's Terms and Conditions. I agree to the Trademark Consent to Use Agreement and agree to adhere to the Logo Usage Guidelines. I affirm that the above information is true and correct to the best of my knowledge. I understand that this information is covered by the Privacy Act statement, above. I affirm that I meet the requirements for joining.*	Yes No	POC Information			Existing - In use
Create Account	Time Zone		POC Information		Select the desired local time and time zone. Dates and times throughout this site will be displayed using this time zone.	Existing - In use
Create Account	To prevent automated SPAM submissions, please prove that you are a human by filling out the text box below based on the image displayed.	I'm not a robot	POC Information		Powered by reCAPTCHA	Existing - In use
Create Activity	Title	Free Text	Activity Details	Unique Details		Existing - In use
Create Activity	Sutitle	Free Text	Activity Details	Unique Details		Existing - In use
Create Activity	Description	Free Text	Activity Details	Unique Details	**Do not enter sensitive Personal Identifiable Information (PII) such as SSN, address, phone number, DOB or driver's license number. Refer to the FEMA Privacy Policy.	Existing - In use
Create Activity	This is a 2018 National Level Exercise (NLE) activity	Yes No	Activity Details	Content		Existing - In use
Create Activity	Activity	Access Alerts and Warnings Assemble or Update Supplies Conduct an Exercise Document and Insure Property Drill or Practice Emergency Response Make Property Safer Participate in a Class, Training, or Discussion Plan with Neighbors Safeguard Documents Test Communication Plans Other	Activity Details	Content		Existing - In use
Create Activity	Audiences *	Child Care Center, School, College/University Faith-Based Organization Individual/Family/Neighborhood Military Non-Profit/Volunteer Organization Private Sector/Business Public Sector/Government (non-military) Whole Community Event (multiple sectors participating) Other	Activity Details	Audience Type		Existing - In use
Create Activity	Hazards *	Active Shooter Earthquake Flood Hurricane Tornado Wildfire Winter Storm Other	Activity Details	Hazards		Existing - In use
Create Activity	Activity Details: When	All Day Show End Date Date (mm/dd/yyyy) Time	Activity Details	When		Existing - In use
Create Activity	This is an online activity and does not have a geographic address	Yes No	Activity Details	Location		Existing - In use
Create Activity	Activity Details: Where	Country Address 1 Address 2 City State Zip Code	Activity Details	Location		Existing - In use
Create Activity	Participants	Free Text	Activity Details	Number Participants		Existing - In use
Create Activity	Are participants in multiple locations?	None No Across City/County Across State Across Country	Activity Details	Location		Existing - In use
Create Activity	Is this activity public?	Public Private	Activity Details	Where	Public activities will be displayed in the activities calendar and America&s PrepareAthon! website.	Existing - In use
Create Activity	URL	Free Text	Activity Details	Unique Details	If there is a web page where people can find more information about the activity, enter the link here.	Existing - In use
Create Activity	URL Title	Free Text	Activity Details	Unique Details	The link title is limited to 128 characters maximum.	Existing - In use
Create Activity	Are you doing this activity in affiliation with another organization or campaign?	Yes No	Activity Details	Unique Details		Existing - In use
Create Activity	Will you be the point of contact for this activity?	Yes No	POC Information			Existing - In use
Create Activity	Please enter the name, organization and email address of the contact person for this activity. Name	Free Text	POC Information			Existing - In use
Create Activity	Organization	Free Text	POC Information			Existing - In use
Create Activity	Email	Free Text	POC Information			Existing - In use
Experience	Overall, how well does the site meet your needs?	Likert Scale	Feedback	Web User		New
Experience	How easy was it to find what were looking for?	Likert Scale	Feedback	Web User		New
Experience	Did it take you more or less time than you expected to find what you were looking for on our website?	Likert Scale	Feedback	Web User		New
Experience	How visually appealing in our website?	Likert Scale	Feedback	Web User		New
Experience	How easy it is to understand the information on our website?	Likert Scale	Feedback	Web User		New
Experience	How much do you trust the information on our website?	Likert Scale	Feedback	Web User		New
Experience	How likely is it that you would recommend our website to a friend or colleague?	Likert Scale	Feedback	Web User		New
Experience	What is your reason for visiting our site today?	Preparedness Program Research Hazards	Feedback	Web User		New
Experience	Did you accomplish your goal for visiting our site?	Yes Yes, after searching for some time No	Feedback	Web User		New
Experience	Why have you decided to exit the site?	I found what I needed I can't find what I need I'm confused by the information I want to tell others	Feedback	Web User		New
Materials Ordering	Is this request to support a scheduled training?	Yes No	Activity Details			New
Materials Ordering	Start date of scheduled training		Activity Details			New
Materials Ordering	Please describe training	Free Text	Activity Details			New
Materials Ordering	Instructions for Requesting Publications Use the tables on the following pages to enter the quantity of each publication being requested. All requests require FEMA approval prior to shipment. Allow 2–3 weeks for delivery.		Information Text			New
Materials Ordering	Community Emergency Response Team (CERT)To receive printed CERT training materials, the CERT team must be registered in the CERTNational Database. Teams can register at https://community.fema.gov/Register.The publication requester name must match the point of contact listed in the CERT National Database		Information Text			New
Materials Ordering	Contact Us To place an order, requesters must send the completed and signed order form via email, fax, or the U.S. Postal Service. Requesters may also call for assistance. Contact Information Email: FEMAPubs@gpo.govPhone: 719-295-2676 Fax: 719-948-9724 Mail: Pueblo Distribution Center 31451 United Ave. Pueblo, CO 81001		Information Text			New
Materials Ordering	Organization/Agency/Company Name		POC Information			New
Materials Ordering	Requestor Name		POC Information			New
Materials Ordering	Job Title/Position		POC Information			New
Materials Ordering	Email Address		POC Information			New
Materials Ordering	Delivery Address		POC Information			New
Materials Ordering	City		POC Information			New
Materials Ordering	State		POC Information			New
Materials Ordering	Zip Code		POC Information			New
Materials Ordering	Phone Number		POC Information			New
Materials Ordering	Publication Number		Order Form			New
Materials Ordering	Publication Title		Order Form			New
Materials Ordering	Quantity Requested		Order Form			New
Ready 2 Help	How many times will you play this game?	1 2-3 4-5 6+	Activity Details	Frequency		New
Ready 2 Help	Total estimated number of participants	1-10 11-20 21-30 30-40 40+	Activity Details	Number Participants		New
Ready 2 Help	Zip code of delivery: Please enter the zip code of the first delivery if providing multiple deliveries.	Free Text	Activity Details	Location		New
Ready 2 Help	Audience type? (select all that apply)	School Afterschool program Youth Organization Faith-Based Organization Other	Activity Details	Audience Type		New
Ready 2 Help	Age range of learners: (select all that apply)	Under 6 6-8 8-10 10-12 12-14 14+	Activity Details	Age		New
Ready 2 Help	Would you like to receive additional information about emergency preparedness?	Yes No If yes, please provide your email address:	Future Communication			New
Until Help Arrives	How many times will you teach this course?	1 2-3 4-5 6+	Activity Details	Frequency		New
Until Help Arrives	Estimated number of learners per course?	1-10 11-20 21-30 30-40 40+	Activity Details	Number Participants		New
Until Help Arrives	Zip code of delivery? Please, enter zip code of first delivery if offering more than one	Free Text	Activity Details	Location		New
Until Help Arrives	Audience type? (select all that apply)	Student Local Government Youth Organization Faith-Based Organization Business General Public Other	Activity Details	Audience Type		New
Until Help Arrives	Age range of learners? (select all that apply)	Under 12 12-18 18-30 30-50 50+	Activity Details	Age		New
Until Help Arrives	Which modules do you plan to teach? (select all that apply)	Module 1: You Make a Difference Module 2: Call 9-1-1 Module 3: Stay Safe Module 4: Stop the Bleeding Module 5: Position the Injured Module 6: Provide Comfort	Activity Details	Content		New
Until Help Arrives	How do you want your name to appear on your certificate?	Free Text	Activity Details	Unique Details		New
Until Help Arrives	This course taught me valuable concepts.	Strongly Disagree Disagree Neutral Agree Strongly Agree Please provide additional comments below.	Feedback			New
Until Help Arrives	After taking this course, I am more likely to provide help to an injured person in an emergency situation.	Agree Disagree	Feedback			New
Until Help Arrives	Which modules did you complete? (select all that apply)	Module 1: You Make a Difference Module 2: Call 9-1-1 Module 3: Stay Safe Module 4: Stop the Bleeding Module 5: Position the Injured Module 6: Provide Comfort	Feedback			New
Until Help Arrives	What could make this course better?	Free Text	Feedback			New
Until Help Arrives	Why did you take this course? (select all that apply)	To fulfill a requirement To broaden my understanding and awareness To improve my response in an emergency situation To increase my level of comfort in providing emergency medical care To satisfy my curiosity	Feedback			New
Until Help Arrives	How did you hear about this course? (select all that apply)	Internet search Word of mouth Advertisement Social Media Other	Feedback			New
Until Help Arrives	Would you like to receive additional information about emergency preparedness?	Yes No If yes, please provide your email address:	Future Communication			New
Until Help Arrives	Would you like to receive additional information about emergency preparedness?	Yes No If yes, please provide your email address:	Future Communication			New

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Sheet 3: PRA Tables

Estimated Annualized Burden Hours and Costs
Type of Respondent	Form Name / Form Number	No. of Respon-dents	No. of Responses per Respon-dent	Total No. of Responses	Avg. Burden per Response (in hours)	Total Annual Burden (in hours)	Avg. Hourly Wage Rate	Total Annual Respondent Cost
Individuals or Households; Farms; Business or other for-profit; Federal Government; Not-for-profit Institutions; State, local or Tribal Government	Preparedness Activity Web Collection / FEMA Form 008-0-8	80,500.00	1.00	80,500.00	0.083	6,708.33	$24.07	$161,469.58		From Form 0134
Same respondents	Preparedness Activity Feedback Form , FEMA Form 519-0-11	20,125.00	1	20,125.00	0.083	1,677.08	$24.07	$40,367.40		From Form 0130
Total		$100,625.00		$100,625.00		$8,385.42		$201,836.98
Itemized Changes in Annual Burden Hours
Data Collection Activity/Instrument	Program Change (hours currently on OMB Inventory)	Program Change (New)	Difference	Adjustment (hours currently on OMB Inventory)	Adjustment (New)	Difference
Preparedness Activity Web Collection / FEMA Form 008-0-8	15,000	6,708.33	-8291.67	0	0	0		From Form 0134
Preparedness Activity Feedback Form , FEMA Form 519-0-11	4250	1,677.08	-2572.92	0	0	0		From Form 0130
			0			0
			0			0
			0			0
			0			0
Total	19250	8385.41666666667	-10864.5833333333	0	0	0
Itemized Changes in Annual Cost Burden
Data Collection Activity/Instrument	Program Change (hours currently on OMB Inventory)	Program Change (New)	Difference	Adjustment (hours currently on OMB Inventory)	Adjustment (New)	Difference
Preparedness Activity Web Collection / FEMA Form 008-0-8	$547,050.00	$161,469.58	$(385,580.42)	$-	$-	$-		From Form 0134
Preparedness Activity Feedback Form , FEMA Form 519-0-11	$-	$40,367.40	$40,367.40	$-	$-	$-		From Form 0130
			$-			$-
			$-			$-
			$-			$-
			$-			$-
Total	$547,050.00	$201,836.98	$(345,213.02)	$-	$-	$-