Public Assistance Program

Forms and Documents

Document Name	Status
Form FEMA Form 009-0-49 Request for Public Assistance Form	Modified
Form FEMA Form 009-0-91 Project Worksheet Photo Sheet Form	New
Form FEMA Form 009-0-91 Project Worksheet Maps and Sketches Sheet Form	New
Form FEMA Form 009-0-91 Project Worksheet Cost Estimate Continuation Sheet and Cost Overruns Form	New
Form FEMA Form 009-0-91 Project Work Sheet Damage Description and Scope of Work Form	New
Form FEMA Form 009-0-12 Force Account Equipment Summary Record Form	Modified
Form FEMA Form 009-0-12 Contract Work Summary Record Form	Modified
Form FEMA Form 009-0-12 Rented Equipment Summary Record Form	Modified
Form FEMA Form 009-0-12 Materials Summary Record Form	Modified
Form FEMA Form 009-0-12 Force Account Labor Summary Form	Modified
Form FEMA Form 009-0-12 PNP Facility Questionnaire Form	Modified
Form FEMA Form 009-0-12 Applicant's Benefits Calculation Worksheet Form	Modified
Form FEMA Form 90-120 Special Considerations Questions Form	Modified
Form FEMA Form 009-0-91 Project Worksheet Form and Instruction	Modified
Form FEMA Form 009-0-11 Progress Report Form and Instruction	Modified
Final_Supporting_Statement 06242013 (2).doc Supporting Statement A	2013-06-24
PIA FEMA Grant Management Programs PIA 7-14-2009.pdf Supplementary Document	2013-04-25
SORN DHS-FEMA-004 Grant Management Information Files 080709.pdf Supplementary Document	2013-04-25
Final PTA 022013.pdf Supplementary Document	2013-04-16
Pub. 30 Day FRN 16600017.pdf Supplementary Document	2013-04-16
Pub. 60 Day FRN 02152013.pdf Supplementary Document	2013-04-16
Public Law 111-5 Section 601.pdf Supplementary Document	2010-02-23
Title 44 CFR 206.pdf Supplementary Document	2010-02-23
State_Administrative_Plan_outline.pdf Supplementary Document	2010-02-05
Public Assistance Guide.pdf Supplementary Document	2010-02-05
stafford_act.pdf Supplementary Document	2010-01-29
Title 44 CFR Part 206 (221-228) Public Assistance 10-1-02.pdf Supplementary Document	2008-07-29
Title 44 CFR Part 206 (201-208) Public Assistance 10-1-02.pdf Supplementary Document	2008-07-29

IC Document Collections

IC ID	Document Title	Status
41294	Request for Public Assistance Form	Modified
206469	Project Worksheet Photo Sheet Form	New
206468	Project Worksheet Maps and Sketches Sheet Form	New
206467	Project Worksheet Cost Estimate Continuation Sheet and Cost Overruns Form	New
206466	Project Work Sheet Damage Description and Scope of Work Form	New
191944	Request for Additional Funding Cost Overruns for Large Projects	Removed
191943	Request for Time Extension	Removed
191942	State Administrative Plan - Submission of Amendments After a Declaration	Removed
191941	State Administrative Plan and Amendments	Modified
190427	Recommendation for Arbitration	Removed
190424	Request for Arbitration and Recommendation from Hurricanes Katrina or Rita	Modified
190423	Request for Second Appeal and Recommendation	Removed
190419	Request for Appeals and Recommendation	Modified
185911	Force Account Equipment Summary Record Form	Modified
185910	Contract Work Summary Record Form	Modified
185909	Rented Equipment Summary Record Form	Modified
185908	Materials Summary Record Form	Modified
185907	Force Account Labor Summary Form	Modified
185906	PNP Facility Questionnaire Form	Modified
185903	Applicant's Benefits Calculation Worksheet Form	Modified
185901	Special Considerations Questions Form	Modified
185900	Project Worksheet Form and Instruction	Modified
185897	Progress Report Form and Instruction	Modified

ICR Details

OMB Control No: 1660-0017	ICR Reference No: 201304-1660-001
Status: Historical Active	Previous ICR Reference No: 201001-1660-004
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 with change	Conclusion Date: 06/24/2013
	Date Received in OIRA: 04/30/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2016	36 Months From Approved	06/30/2013
Responses	346,940	0	200,039
Time Burden (Hours)	361,766	0	167,554
Cost Burden (Dollars)	0	0	0

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Abstract: The Public Assistance Program assist State, Tribal and local governments and certain private Non-Profit entities with the responses to and recovery from disasters following a Presidentially declared major disasters and emergencies. The information collected is utilized by FEMA to make determinations for Public Assistance grants based on the information supplied by the respondents.

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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:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 8161	02/05/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 21961	04/02/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 18

IC Title	Form No.	Form Name
Force Account Labor Summary	FEMA Form 009-0-123	Force Account Labor Summary Record
Applicant's Benefits Calculation Worksheet	FEMA Form 009-0-128	Applicant's Benefits Calculation Worksheet
Recommendation for Arbitration
Project Work Sheet Damage Description and Scope of Work	FEMA Form 009-0-91A	Project Worksheet - Damage Description and Scope of Work Continuation Sheet
Project Worksheet Maps and Sketches Sheet	FEMA Form 009-0-91C	Project Worksheet - Maps and Sketches Sheet
State Administrative Plan and Amendments
Request for Arbitration and Recommendation from Hurricanes Katrina or Rita
Project Worksheet	FEMA Form 009-0-91	Project Worksheet
Force Account Equipment Summary Record	FEMA Form 009-0-127	Force Account Equipment Summary Record
Rented Equipment Summary Record	FEMA Form 009-0-125	Rented Equipment Summary Record
Progress Report	FEMA Form 009-0-111	Quarterly Progress Report
Request for Time Extension
PNP Facility Questionnaire	FEMA Form 009-0-121	PNP Facility Questionaire
Materials Summary Record	FEMA Form 009-0-124	Materials Summary Record
Contract Work Summary Record	FEMA Form 009-0-126	Contract Work Summary Record
Request for Public Assistance	FEMA Form 009-0-49	Request for Public Assistance
Special Considerations Questions	FEMA Form 90-120	Special Consideration Questions
Project Worksheet Photo Sheet	FEMA Form 009-0-91D	Project Worksheet-Photo Sheet
Project Worksheet Cost Estimate Continuation Sheet and Cost Overruns	FEMA Form 009-0-91B	Project Worksheet-Cost Estimate Continuation Sheet
Request for Second Appeal and Recommendation
State Administrative Plan - Submission of Amendments After a Declaration
Request for Additional Funding Cost Overruns for Large Projects
Request for Appeals and Recommendation

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ICR Summary 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	346,940	200,039	0	161,741	-14,840	0
Annual Time Burden (Hours)	361,766	167,554	0	199,485	-5,273	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: Miscellaneous Actions

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

Burden Reduction Due to: Miscellaneous Actions

Short Statement: FEMA Form 009-0-49 had decreased in number of responses; FEMA Forms 009-0-91;009-0-91A;009-0-91B;009-0-91C and 009-0-91D were separated and recalculated and has increase in burden hours; FEMA Form 009-0-120 number of responses have decreased; FEMA Form 009-0-128 number of responses have decreased. The State Administrative Plan and Administrative Plan Amendment were combined and decreased in the number of responses. Request for Appeals and Recommendation was combined with first, second, and recommendation for appeals, therefore a increased in the number of responses. The Request for Arbitration and Recommendation for Hurricanes Katrina or Rita was combine with Recommendations and there was a decrease in the number of responses.

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Annual Cost to Federal Government: $748,782

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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: 04/30/2013

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