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Agency Information Collection Activities: Proposed Collection; Comment Request, OMB No. 1660-0011; Debt Collection Financial Statement

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Federal Emergency Management Agency, DHS.


Notice; 60-day notice and request for comments; revision of a currently approved information collection; OMB No. 1660-0011; FEMA Form 127-0-1 (formerly FEMA Form 22-13), Debt Collection Financial Statement.


The Federal Emergency Management Agency, as part of its continuing effort to reduce paperwork and respondent burden, invites the general public and other Federal agencies to take this opportunity to comment on a proposed revision of a currently approved information collection. In accordance with the Paperwork Reduction Act of 1995, this notice seeks comments concerning the collection of information related to disaster program accounts and debts receivable.

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Comments must be submitted on or before January 24, 2011.


To avoid duplicate submissions to the docket, please use only one of the following means to submit comments:

(1) Online. Submit comments at under Docket ID FEMA-2010-0060. Follow the instructions for submitting comments.

(2) Mail. Submit written comments to Docket Manager, Office of Chief Counsel, DHS/FEMA, 500 C Street, SW., Room 835, Washington, DC 20472-3100.

(3) Facsimile. Submit comments to (703) 483-2999.

(4) E-mail. Submit comments to Include Docket ID FEMA-2010-0060 in the subject line.

All submissions received must include the agency name and Docket ID. Regardless of the method used for submitting comments or material, all submissions will be posted, without change, to the Federal eRulemaking Portal at, and will include any personal information you provide. Therefore, submitting this information makes it public. You may wish to read the Privacy Act notice that is available via the link in the footer of

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Michael H. Komack, Financial Policy Specialist, Financial Policy Staff, Office of the Chief Financial Officer, FEMA, 202-646-4164. You may contact the Records Management Division for copies of the proposed collection of information at facsimile number (202) 646-3347 or e-mail address:

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Under the Debt Collection Improvement Act as amended (31 U.S.C. 3701, et seq.), the Federal Claims Collection Standards (31 CFR 901), and DHS regulations (6 CFR 11), the Administrator of FEMA is: (1) Required to attempt collection of all debts owed to the United States arising out of activities of FEMA; and (2) for debts not exceeding $100,000, authorized to compromise such debts or terminate collection action completely where it appears that no person is liable for such debt or has the present or prospective financial ability to pay a significant sum, or that the cost of collecting such debt is likely to exceed the amount of the recovery (31 U.S.C. 3711(a)(2)).

Collection of Information

Title: Debt Collection Financial Statement.

Type of Information Collection: Revision of a currently approved information collection.

OMB Number: 1660-0011.

Form Titles and Numbers: FEMA Form 127-0-1 (formerly FEMA Form 22-13), Debt Collection Financial Statement.

Abstract: FEMA may request debtors to provide personal financial information on FEMA Form 127-0-1 concerning their current financial position. With this information, FEMA evaluates whether to allow its debtors to pay their FEMA debts under installment repayment agreements and if so, under what terms. FEMA also uses this data to determine whether to compromise, suspend, or completely terminate collection efforts on respondent's debts. This data is also used to locate the debtor's assets if the debts are sent for judicial enforcement.

Affected Public: Individuals or households.

Estimated Total Annual Burden hours: 1,200 Hours.

Estimated Annualized Burden Hours and Costs

Type of respondentForm name/form numberNumber of respondentsNumber of responses per respondentTotal number of responsesAvg. burden per response (in hours)Total annual burden (in hours)Avg. hourly wage rateTotal annual respondent cost
Individuals or HouseholdsFEMA Form 127-0-1/Debt Collection Financial Statement1,60011,60045 minutes1,200$41.33$49,596.00

Estimated Cost: There are no annual operation, maintenance, capital or start up costs associated with this collection.


Comments may be submitted as indicated in the ADDRESSES caption above. Comments are solicited to (a) evaluate whether the proposed data collection is necessary for the proper performance of the agency, including whether the information shall have practical utility; (b) evaluate the accuracy of the agency's estimate of the burden of the proposed collection of information, including the validity of the methodology and assumptions used; (c) enhance the quality, utility, and clarity of the information to be collected; and (d) minimize the burden of the collection of information on those who are to respond, including through the use of appropriate automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submission of responses.

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Dated: November 16, 2010.

Dr. Lesia M. Banks,

Director, Records Management Division, Mission Support Bureau, Federal Emergency Management Agency, Department of Homeland Security.

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[FR Doc. 2010-29557 Filed 11-23-10; 8:45 am]