Department of Homeland Security
Federal Emergency Management Agency
DisasterAssistance.gov Customer Satisfaction Survey

OMB Control Number: 1660-0130
Expiration Date: 05/31/2018
PAPERWORK BURDEN DISCLOSURE NOTICE
FEMA Form 519-0-17
Public reporting burden for this form is estimated to average 15 minutes per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting the form. This collection of information is voluntary. You are not required to respond to this collection of information unless it displays a valid OMB control number. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street SW, Washington, DC 20472, Paperwork Reduction Project (1660-0130). NOTE: Do not send your completed form to this address.


All questions with an ( * ) require an answer.  When leaving comments, please do not include any personal information (social security number, phone, address, etc.)

Your opinion matters! The answers you provide will help us improve our site for future users. 

* 1. How did you find out about our website?  Select all that apply:

* 2. How would you rate your overall online experience?

* 3. Were you able to complete the purpose of your visit?

* 4. While using DisasterAssistance.gov, did you visit any pages under the standard website menus?  e.g. Information, Get Assistance, About Us, Help.

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