Outlay Report and Request for Reimbursement For Contruction Progarms

FEMA Emergency Preparedness and Response Directorate Grants Administration Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0025 can be found here:

Documents and Forms

Document Name Document Type
Form FEMA Form 112-0-4 Outlay Report and Request for Reimbursement For Contruction Progarms Form and Instruction
FEMA Form 112-0-4 Outlay Report and Request for Reimbursement for Construc 112-0-4 Previously FF20-17.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Outlay Report and Request for Reimbursement For Contruction Progarms	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 44 CFR Part 13 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FEMA Form 112-0-4	Outlay Report and Request for Reimbursement for Construction Programs	112-0-4 Previously FF20-17.pdf		Yes	No	Fillable Printable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	54,429	3,421	51,008
Annual IC Time Burden (Hours)	936,179	58,841	877,338
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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