Information Collection Request

Survivor Sheltering Assessment

ICR 202009-1660-001 · OMB 1660-0142 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form FEMA Form 009-0-42 Survivor Sheltering Assessment Form and Instruction New Available
Emergency Justification Memo_PA NCS COVID19 082620-final.pdf Supplementary Document Uploaded 2020-09-04 Available
LAD_SSAT User Guide 20170901.pdf Supplementary Document Uploaded 2017-09-01 Available
1660-0142 Supporting Statement A Emergency.docx Supporting Statement A Uploaded 2020-09-03 Repair queued
Privacy Notice SSAT.doc Supplementary Document Uploaded 2017-08-31 Available
DHS-SORN-2013-0029-0001.pdf Supplementary Document Uploaded 2017-08-30 Available
privacy_PIA_fema_daip_012a_2012.pdf Supplementary Document Uploaded 2017-08-30 Available
privacy_PIA_fema_027_2012.pdf Supplementary Document Uploaded 2017-08-30 Available
42 USC 5174.pdf Supplementary Document Uploaded 2017-08-30 Available
44 CFR Part 206.110.pdf Supplementary Document Uploaded 2017-08-30 Available
Stafford Act Booklet 042213.pdf Supplementary Document Uploaded 2017-08-30 Available
IC Document Collections
IC IDCollectionTypeStatusForm
243459 Survivor Sheltering Assessment Form and Instruction New
228136 Survivor Sheltering Assessment Tool Other-Survivor Sheltering Assessment Tool (App) Unchanged
ICR Details
1660-0142 202009-1660-001
Active 201802-1660-010
DHS/FEMA
Survivor Sheltering Assessment
Revision of a currently approved collection   No
Emergency 09/05/2020
Approved without change 09/08/2020
Retrieve Notice of Action (NOA) 09/04/2020
  Inventory as of this Action Requested Previously Approved
03/31/2021 6 Months From Approved 05/31/2022
51,200 0 31,200
8,535 0 5,201
0 0 0

This collection is used to collect information from survivors in shelters regarding the pre-disaster housing situation and post disaster housing plans. The information will be used by FEMA to understand the scope of the FEMA requirement to provide housing and rental assistance to those displaced by natural and manmade disaster. This will ensure that FEMA delivers housing and rental services without duplicating the benefits other Agencies are responsible for providing based on survivor’s pre-disaster housing situation. Aggregated reports will be used by staff in the Joint Field Office to plan and execute shelter depopulation strategies. Individual survivor information collected with this assessment will be used solely for the planning and delivery of FEMA services.
FEMA is implementing an alternate method to support immediate needs for Survivor Sheltering Assessment in Support of FEMA Public Assistance Non-Congregate Sheltering Data Sharing during the COVID-19 Public Health Emergency (Interim) FP 104-009-18 to include an alternate process to be utilized by State, Tribal or Territorial (STT) governments to collect information from the Shelter Resident and provide that data to FEMA in response to the COVID-19 pandemic.

US Code: 42 USC 5174 Name of Law: Disaster Mitigation Act of 2000
   PL: Pub.L. 93 - 288 0000 Name of Law: Name of Law: Robert T. Stafford Disaster Relief and Emergency Assistance Act
  
None

Not associated with rulemaking

No

2
IC Title Form No. Form Name
Survivor Sheltering Assessment Tool
Survivor Sheltering Assessment FEMA Form 009-0-42AV Survivor Sheltering Assessment Alternate Version

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 51,200 31,200 0 20,000 0 0
Annual Time Burden (Hours) 8,535 5,201 0 3,334 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
For the Survivor Sheltering Assessment collection, previously approved burden hours were estimated at 5,201 for the full collection. The burden hours are increased by 3,334 to add the alternative version for the COVID-19 sheltering data for a total of 8,535 hours.

$273,356
No
    Yes
    Yes
No
No
No
Yes
Millicent Brown 202 646-2814 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/04/2020