Information Collection

RLS Hospital and Medical Center

IC 229520 under ICR 201712-1660-001 · OMB 1660-0083.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0083 can be found here:

Documents and Forms

Document Name Document Type
Form FEMA Form 116-0-1b RLS Hospital and Medical Center Form and Instruction
FEMA Form 116-0-1b RLS Hospital and Medical Center FEMA Form 116-0-1b RLS Hospital and Medical Center Draft version 12-21-2017.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	RLS Hospital and Medical Center	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

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 116-0-1b	RLS Hospital and Medical Center	FEMA Form 116-0-1b RLS Hospital and Medical Center Draft version 12-21-2017.pdf		No		Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records
Title: DHS/FEMA-009 - Hazard Mitigation Disaster Public Assistance and Disaster Loan Programs	FR Citation: 79 FR 16015

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

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	2	2
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.