Hermits Peak/Calf Canyon Claims Office Customer Satisfaction Surveys

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Documents and Forms

Document Name Document Type
Form FEMA Form-104-FY-2 Hermits Peak/Calf Canyon Claims Office Customer Satisfaction Surveys Form and Instruction
FEMA Form-104-FY-2 Proof of Loss Survey -Phone FF-104-FY-24-118_POL_2025.docx Form and Instruction
FEMA Form FF-104-F Assessment Survey - Phone FF-104-FY-24-119_Assessment_2025.docx Form and Instruction
FEMA Form FF-104-F Acknowledgement Survey – Phone FF-104-FY-24-120_Acknowledgement_2025.docx Form and Instruction
1660-0130_HPCC_Surveys_08042025.pdf Generic Application IC Document

Information Collection (IC) Details

IC Title:	Hermits Peak/Calf Canyon Claims Office Customer Satisfaction Surveys	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	FEMA Form-104-FY-24-118	Proof of Loss Survey -Phone	FF-104-FY-24-118_POL_2025.docx	No	Fillable Printable
Form and Instruction	FEMA Form FF-104-FY-24-119	Assessment Survey - Phone	FF-104-FY-24-119_Assessment_2025.docx	No	Fillable Printable
Form and Instruction	FEMA Form FF-104-FY-24-120	Acknowledgement Survey – Phone	FF-104-FY-24-120_Acknowledgement_2025.docx	No	Fillable Printable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 7,400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	7,400	7,400
Annual IC Time Burden (Hours)	1,335	1,335
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Application	1660-0130_HPCC_Surveys_08042025.pdf	08/05/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.