Public Assistance Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FEMA Form 90-49 Request for Public Assistance	Form	Modified	Available
Form FEMA Form 90-127 Force Account Equipment Summary Record	Form	Modified	Available
Form FEMA Form 90-126 Contract Work Summary Record	Form	Modified	Available
Form FEMA Form 90-125 Rented Equipment Summary Record	Form	Modified	Available
Form FEMA Form 90-124 Materials Summary Record	Form	Modified	Available
Form FEMA Form 90-123 Force Account Labor Summary Record	Form	Modified	Available
Form FEMA Form 90-121 PNP Facility Questionaire	Form	Modified	Available
Form FEMA Form 90-128 Applicant's Benefits Calculation Worksheet	Form	Modified	Available
Form FEMA Form 90-120 Special Consideration Questions	Form	Modified	Available
Form FEMA Form 90-91D Project Worksheet - Photo Sheet	Form	Modified	Available
Form FEMA Form 90-91C Project Worksheet - Maps and Sketches	Form	Modified	Available
Form FEMA Form 90-91B Project Worksheet - Cost Etimate Continuation Sheet	Form	Modified	Available
Form FEMA Form 90-91A Project Worksheet - Damage Description and Scope of Work Continuation Sheet	Form	Modified	Available
Form FEMA Form 90-91 Project Worksheet	Form and Instruction	Modified	Available
Public Law 111-5 Section 601.pdf	Supplementary Document	Uploaded 2010-02-23	Available
Title 44 CFR 206.pdf	Supplementary Document	Uploaded 2010-02-23	Available
Narrative of Revisions 2-18-10.doc	Supplementary Document	Uploaded 2010-02-24	Available
30-day FRN published 2-8-10.pdf	Supplementary Document	Uploaded 2010-02-17	Available
PA Administrative Costs.pdf	Supplementary Document	Uploaded 2010-02-05	Available
State_Administrative_Plan_outline.pdf	Supplementary Document	Uploaded 2010-02-05	Available
Public Assistance Guide.pdf	Supplementary Document	Uploaded 2010-02-05	Repair queued
60-day FRN published 11-17-09.pdf	Supplementary Document	Uploaded 2010-02-02	Available
stafford_act.pdf	Supplementary Document	Uploaded 2010-01-29	Available
SupportingStatement 1660-0017 2-22-10 final.doc	Supporting Statement A	Uploaded 2010-02-24	Available
Title 44 CFR Part 206 (221-228) Public Assistance 10-1-02.pdf	Supplementary Document	Uploaded 2008-07-29	Available
Title 44 CFR Part 206 (201-208) Public Assistance 10-1-02.pdf	Supplementary Document	Uploaded 2008-07-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
41294	Public Assistance Progress Report and Program Forms	Form	Modified	Request for Public Assistance
191944	Request for Additional Funding Cost Overruns for Large Projects		New
191943	Request for Time Extension		New
191942	State Administrative Plan - Submission of Amendments After a Declaration		New
191941	State Administrative Plan		New
190427	Recommendation for Arbitration		Unchanged
190424	Request for Arbitration		Unchanged
190423	Request for Second Appeal and Recommendation		Modified
190419	Request for First Appeals and Recommendation		Modified
185911	Force Account Equipment Summary Record	Form	Modified	Force Account Equipment Summary Record
185910	Contract Work Summary Record	Form	Modified	Contract Work Summary Record
185909	Rented Equipment Summary Record	Form	Modified	Rented Equipment Summary Record
185908	Materials Summary Record	Form	Modified	Materials Summary Record
185907	Force Account Labor Summary	Form	Modified	Force Account Labor Summary Record
185906	PNP Facility Questionnaire	Form	Modified	PNP Facility Questionaire
185903	Applicant's Benefits Calculation Worksheet	Form	Modified	Applicant's Benefits Calculation Worksheet
185901	Special Considerations Questions	Form	Modified	Special Consideration Questions
185900	Project Worksheet and Continuation Forms	Form	Modified	Project Worksheet - Photo Sheet
185900	Project Worksheet and Continuation Forms	Form	Modified	Project Worksheet - Maps and Sketches
185900	Project Worksheet and Continuation Forms	Form	Modified	Project Worksheet - Cost Etimate Continuation Sheet
185900	Project Worksheet and Continuation Forms	Form	Modified	Project Worksheet - Damage Description and Scope of Work Continuation Sheet
185900	Project Worksheet and Continuation Forms	Form and Instruction	Modified	Project Worksheet
185897	Progress Report		Modified

ICR Details

OMB Control No: 1660-0017	ICR Reference No: 201001-1660-004
Status: Historical Active	Previous ICR Reference No: 200908-1660-003
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: Public Assistance Program
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/24/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/25/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2013	36 Months From Approved	04/30/2010
Responses	200,039	0	185,737
Time Burden (Hours)	167,554	0	155,998
Cost Burden (Dollars)	0	0	0

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Abstract: This collection constitutes the mechanism for the administration of the Public Assistance Program. The application process contains recordkeeping and reporting requirements to ensure up-to-date information on project status to States and FEMA.

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Authorizing Statute(s): PL: Pub.L. 93 - 288 406-407 Name of Law: Robert T. Stafford Disaster Relief and Emergency Assistance Act
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 5 601 Name of Law: American Recovery and Reinvestment Act of 2009

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1660-AA63	Final or interim final rulemaking	74 FR 44761	08/31/2009

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 59206	11/17/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 19

table that charts list of burden

IC Title	Form No.	Form Name
Applicant's Benefits Calculation Worksheet	FEMA Form 90-128	Applicant's Benefits Calculation Worksheet
Contract Work Summary Record	FEMA Form 90-126	Contract Work Summary Record
Force Account Equipment Summary Record	FEMA Form 90-127	Force Account Equipment Summary Record
Force Account Labor Summary	FEMA Form 90-123	Force Account Labor Summary Record
Materials Summary Record	FEMA Form 90-124	Materials Summary Record
PNP Facility Questionnaire	FEMA Form 90-121	PNP Facility Questionaire
Progress Report
Project Worksheet and Continuation Forms	FEMA Form 90-91C, FEMA Form 90-91, FEMA Form 90-91A, FEMA Form 90-91D, FEMA Form 90-91B	Project Worksheet ,   Project Worksheet - Damage Description and Scope of Work Continuation Sheet ,   Project Worksheet - Cost Etimate Continuation Sheet ,   Project Worksheet - Maps and Sketches ,   Project Worksheet - Photo Sheet
Public Assistance Progress Report and Program Forms	FEMA Form 90-49	Request for Public Assistance
Recommendation for Arbitration
Rented Equipment Summary Record	FEMA Form 90-125	Rented Equipment Summary Record
Request for Additional Funding Cost Overruns for Large Projects
Request for Arbitration
Request for First Appeals and Recommendation
Request for Second Appeal and Recommendation
Request for Time Extension
Special Considerations Questions	FEMA Form 90-120	Special Consideration Questions
State Administrative Plan
State Administrative Plan - Submission of Amendments After a Declaration

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ICR Summary of Burden

table that charts list 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	200,039	185,737	3,808	0	10,494	0
Annual Time Burden (Hours)	167,554	155,998	2,744	9	8,803	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

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

Burden Reduction Due to:

Short Statement: FEMA Form 90-49, Request for Public Assistance; FEMA Form 90-91, Project Worksheet (PW); FEMA Form 90-91A, Project Worksheet - Damage Description and Scope of Work Continuation Sheet; FEMA Form 90-91B, Project Worksheet - Cost Estimate Continuation Sheet; FEMA Form 90-91C Project Worksheet - Maps and Sketches Sheet; FEMA Form 90-91D, Project Worksheet - Photo Sheet; FEMA Form 90-120, Special Considerations Questions; FEMA Form 121, PNP Facility Questionnaire; FEMA Form 90-123, Force Account Labor Summary Record; FEMA Form 90-124, Materials Summary Record; FEMA Form 90-125, Rented Equipment Summary Record; FEMA Form 90-126, Contract Work Summary Record; FEMA Form 90-127, Force Account Equipment Summary Record; and FEMA Form 90-128, Applicant’s Benefits Calculation Worksheet, Progress Report, Request for First Appeal and Request for Second Appeal; The expected number of respondents has increased from 53 to 56, increasing the total number of responses accordingly. For the State Administrative Plan, State Administrative Plan – Submission of Amendments after a Declaration, Request for Time Extension and Request for Additional Finding Cost Overruns for Large Projects, these tools have been added into the collection for the first time. For the Recommendation for Arbitration (from the State government manager), the prior calculated responses was off by one and is added here. The Appeals and Arbitration process is a new collection of information. This collection has been amended to include the Appeals and Arbitration process.

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Annual Cost to Federal Government: $664,925

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Yes

Is this ICR related to the Pandemic Response? Uncollected

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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: 02/25/2010

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