Information Collection

Request For Housing Accommodations

IC 181908 under ICR 201401-1660-003 · OMB 1660-0029.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0029 can be found here:

Documents and Forms

Document Name Document Type
Form FEMA Form 119-17-1 Request For Housing Accommodations Form
FEMA Form 119-17-1 Request For Housing Accommodations FEMA Form 119-17-1, 2-4-2014.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request For Housing Accommodations	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 44 CFR Part 15 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FEMA Form 119-17-1	Request For Housing Accommodations	FEMA Form 119-17-1, 2-4-2014.pdf		Yes	Yes	Printable Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title: DHS/FEMA-011 Training and Exercise Program Records System of Records	FR Citation: 76 FR 19107

Number of Respondents: 60	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	6	6
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.