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Crisis Assistance Request Form - (Dept. of State)
Crisis Assistance Request Form - (Dept. of State)
OMB: 1405-0259
IC ID: 261711
OMB.report
STATE/AFA
OMB 1405-0259
ICR 202306-1405-004
IC 261711
( )
Documents and Forms
Document Name
Document Type
Crisis Assistance Request Form - (Dept. of State)
Form and Instruction
Crisis Assistance Request Form
CACMS Public Pages Screenshot 1-27-2-23.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Crisis Assistance Request Form - (Dept. of State)
Agency IC Tracking Number:
IC Status:
New
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
NA
Crisis Assistance Request Form
CACMS Public Pages Screenshot 1-27-2-23.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Disaster Management
Subfunction:
Emergency Response
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
120,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
120,000
0
120,000
0
0
0
Annual IC Time Burden (Hours)
10,000
0
10,000
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
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.