OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

INSPECTION AND ESTIMATE, ADJUSTER'S REPORT, WORKSHEET, NOTICE OF LOSS, PROOF OF LOSS, ETC.

ICR 197709-3067-002 · OMB 3067-0021 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
151796 INSPECTION AND ESTIMATE, ADJUSTER'S REPORT, WORKSHEET, NOTICE OF LOSS, PROOF OF LOSS, ETC. Migrated
ICR Details
3067-0021 197709-3067-002
Historical Active
FEMA
INSPECTION AND ESTIMATE, ADJUSTER'S REPORT, WORKSHEET, NOTICE OF LOSS, PROOF OF LOSS, ETC.
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 09/15/1977
Retrieve Notice of Action (NOA) 09/06/1977
  Inventory as of this Action Requested Previously Approved
07/31/1978 07/31/1978
30,000 0 0
5,000 0 0
0 0 0

None
None
No
1
IC Title Form No. Form Name
INSPECTION AND ESTIMATE, ADJUSTER'S REPORT, WORKSHEET, NOTICE OF LOSS, PROOF OF LOSS, ETC.
  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 30,000 0 0 0 30,000 0
Annual Time Burden (Hours) 5,000 0 0 0 5,000 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
09/06/1977