Information Collection

Video Survey and Answer Sheets - California and Montana

IC 46124 under ICR 200611-0596-002 · OMB 0596-0203.

Documents and Forms

Document Name Document Type
Video Survey and Answer Sheets - California and Montana Form
Answer Sheet - California - English Appendix B1 - Revised 8-24-06 Answer sheet California.doc Form
Answer Sheet - California - Spanish Appendix B2 - Revised 8-24-06 Answer Sheet California Spanish.doc Form
Answer Sheet Montana Appendix B3 - Revised 8-24-06 Answer sheet Montana.doc Form
Video Survey IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Video Survey and Answer Sheets - California and Montana	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	None	Answer Sheet - California - Spanish	Appendix B2 - Revised 8-24-06 Answer Sheet California Spanish.doc	No	Paper Only
Form	None	Answer Sheet Montana	Appendix B3 - Revised 8-24-06 Answer sheet Montana.doc	No	Paper Only
Form	None	Answer Sheet - California - English	Appendix B1 - Revised 8-24-06 Answer sheet California.doc	No	Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	500	500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Video Survey		11/21/2006

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.