Information Collection

FEMA Form 086-0-28(E), Community Visit Report

IC 21079 under ICR 201707-1660-004 · OMB 1660-0023.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0023 can be found here:

Documents and Forms

Document Name Document Type
Screenshots for FEMA Form 086-0-28(E), CAV 7-12-2017.pdf Other-Screenshots

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FEMA Form 086-0-28(E), Community Visit Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screenshots			Screenshots for FEMA Form 086-0-28(E), CAV 7-12-2017.pdf		Yes	Yes	Fillable Printable

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: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	2,000	2,000
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.