Debt Collection Financial Statement

OMB Control No: 1660-0011	ICR Reference No: 202503-1660-001
Status: Active	Previous ICR Reference No: 202006-1660-009
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: Debt Collection Financial Statement
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/19/2026
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/20/2025
Terms of Clearance: The collection has been approved for two years due to non-compliance with the previous terms of clearance: The agency will explore further electronic submission options and whether an ink signature is legally necessary.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2028	36 Months From Approved	01/31/2026
Responses	140	0	300
Time Burden (Hours)	105	0	225
Cost Burden (Dollars)	0	0	0

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Abstract: FEMA Form FF-600-FY-22-102 (formerly 127-0-1) is used to collect information provided voluntarily by the debtor to evaluate the debtor’s financial abilities to determine if they qualify for a payment plan and set repayment terms, or determine a compromise to write-off a debt in part or in full. Financial information obtained is essential to evaluate the debtor’s ability for the payment of the debt in part or in full. Debt may be a recoupment of an ineligible disaster assistance payment or improper payment to an employee.

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Authorizing Statute(s): US Code: 31 USC 3701 Name of Law: Definitions and Applications    US Code: 31 USC 3711 Name of Law: Collection and Compromise

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 4759	01/16/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 17847	04/30/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title Form No. Form Name Debt Collection Financial Statement FEMA Form FF-600-FY-22-102 (formerly 127-0-1) Debt Collection Financial Statement

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ICR Summary of Burden

	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	140	300	0	0	-160	0
Annual Time Burden (Hours)	105	225	0	0	-120	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: There is a decrease in the burden hours due to a decrease in the number of respondents. The overall decrease in annual costs is due to the decrease in the number of respondents.

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Annual Cost to Federal Government: $23,877

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Echo Brathwaite 202 880-6399 [email protected]

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Common Form ICR:  No

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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:
		(a) It is necessary for the proper performance of agency functions;
		(b) It avoids unnecessary duplication;
		(c) It reduces burden on small entities;
		(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
		(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
		(f) It indicates the retention periods for recordkeeping requirements;
		(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
			(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;
		(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
		(i) It uses effective and efficient statistical survey methodology (if applicable); and
		(j) It makes appropriate use of information technology.
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.
Certification Date: 05/20/2025

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