Information Collection

Agent Referral Program Enrollment Form

IC 21138 under ICR 200901-1660-007 · OMB 1660-0059.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0059 can be found here:

Documents and Forms

Document Name Document Type
Form FEMA Form 517-1 Agent Referral Program Enrollment Form Form
FEMA Form 517-1 Agent Referral Program Enrollment Form 517-1 (2).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Agent Referral Program Enrollment Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	FEMA Form 517-1	Agent Referral Program Enrollment Form	517-1 (2).pdf		Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8,779	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	8,779	8,779
Annual IC Time Burden (Hours)	293	293
Annual IC Cost Burden (Dollars)	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.