Information Collection

Application for Surplus Federal Real Property Public Benefit Conveyance and BRAC Program for Emergency Management Use

IC 21177 under ICR 201609-1660-002 · OMB 1660-0080.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0080 can be found here:

Documents and Forms

Document Name Document Type
Form FEMA Form 119-0-1 Application for Surplus Federal Real Property Public Benefit Conveyance and BRAC Program for Emergency Management Use Form and Instruction
FEMA Form 119-0-1 Application for Surplus Federal Real Property Public Ben FEMA Form 119-0-1 Final 11-9-2016.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Surplus Federal Real Property Public Benefit Conveyance and BRAC Program for Emergency Management Use	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 41 CFR 102-75.750-815 (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 and Instruction	FEMA Form 119-0-1	Application for Surplus Federal Real Property Public Benefit Conveyance and BRAC Program for Emergency Management Use	FEMA Form 119-0-1 Final 11-9-2016.pdf		Yes	Yes	Fillable Printable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title: DHS/All-F002 Department of Homeland Security Mailing and Other Lists System of Records	FR Citation: 73 FR 71659

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	20	-30	50
Annual IC Time Burden (Hours)	100	-100	200
Annual IC Cost Burden (Dollars)	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.