Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Case Management Plan – Case Manager Unchanged 9000 9000 0 Form and Instruction 2 Case Management Plan
Case Record Notes – Case Manager Unchanged 9000 9000 0 Form and Instruction 4 Case Record Notes
Disaster Human Services Case Management Intake Assessment – Survivor Unchanged 9000 13500 0 Form and Instruction 1 Disaster Human Services Case Management Intake Assessment Form
Resource Referral Form – Case Manager Unchanged 9000 9000 0 Form and Instruction 3 Resource Referral Form
Survivor Satisfaction Survey – Survivor Unchanged 9000 2250 0 Other-Survey
Total burden requested under this ICR: 45000 42750 0  
To view an IC, click on IC Title