Request for Information (RFI) Letter

W. Craig Fugate Governor name

Administrator Governor

Federal Emergency Management Agency State of State

National Processing Service Center

P.O. Box 10055

Hyattsville, MD 20782 - 8055

1-800-621-FEMA (3362)

Fax No.: 1-800-827-8112 Date: 00/00/0000

FEMA Application No. 000000000 Disaster No. 0000

APPLICANTS NAME

STREET ADDRESS

CITY, STATE ZIP

Dear Ms/Mr Applicants Name:

Our records indicate you may have a need for the type(s) of assistance listed below. However, we need additional information to process your application. Please provide the following information within 21 days of the date of this letter:

Other expenses:

During registration you indicated that you may have a need for child care assistance. FEMA can provide child care assistance as a one-time payment based on your disaster-related needs for up to eight weeks of child care or up to the maximum amount of assistance for child care identified by your State/Tribe, whichever is less.

In order to process your request for child care assistance, we need additional information so we can evaluate your eligibility.

If your household’s child care costs increased due to the disaster, OR your household’s income decreased due to the disaster, please provide the following information to FEMA:

1. Pre- and post-disaster income documentation. This may include paystubs.

2. Pre- and post-disaster child care cost documentation. This may include items such as receipts, affidavits, or estimates for post-disaster child care costs.

Receipts.

• The receipt(s), signed by you and the child care provider, must include the:

• child’s name(s),

• child care provider’s name, address, and phone number,

• time period covered by the receipt (one billing cycle only), and

• total expense for that time period.

• Each receipt should cover one billing cycle for the child care provider (pre- or post-disaster) to allow FEMA to evaluate the costs. FEMA will calculate the weekly costs based on the receipt(s) provided and the billing cycle’s time period.

• The child care provider must be licensed and regulated with your State/Tribal government laws.

Affidavit. An affidavit may only be used if you had child care costs before the disaster, but cannot locate those receipts.

• The affidavit, signed by you and the child care provider, must include the:

• child’s name(s),

• child care provider’s name, address, and phone number,

• time period ordinarily covered by one receipt (one billing cycle only),

• total expense for that time period, and

• the following signed and dated statement: “I declare under penalty of perjury that the information submitted is true and correct.”

• The affidavit should cover one billing cycle for the child care provider to allow FEMA to evaluate the costs.

• The child care provider must be licensed and regulated in accordance with your State/Tribal government laws.

Estimate. An estimate may only be submitted if you intend to use a new child care provider after the disaster and you do not yet have a receipt for a billing cycle. Please only submit an estimate of the expected costs from the child provider you will utilize.

• The estimate, signed by you and the child care provider, must include the:

• child’s name(s),

• child care provider’s name, address, and phone number,

• estimate/rate for a certain time period (for example, weekly estimate, monthly estimate, etc.)

• The child care provider must be licensed and regulated with your State/Tribal government laws.

3. For children ages 14 up to18, who have a disability and who need assistance in caring for themselves, please provide a signed and dated statement from a medical professional stating that your child has a need for child care services due to a disability. Please note: this FEMA program funds child care only and cannot be used for medical assistance.

4. Signed and dated statements acknowledging:

   • The expected length of time you will have a disaster-related need for FEMA child care assistance. For example, the statement could read: “My household has a disaster-related need for child care assistance. My need for child care assistance will continue for ___ weeks.”

   • You have not received child care emergency services, assistance, or compensation from any other government agency, employer, insurance, or any other source that meets your current child care needs. For example, the statement could read: “My household has a disaster-related need for child care assistance because our child care needs are not being met by another source, i.e., my household is not receiving child care assistance from another public agency such as the U.S. Department of Health and Human Services, a State or local agency, or any other agency or organization providing child care.” If you are receiving child care assistance or compensation from another source that meets your current child care needs, including child care assistance under FEMA’s Public Assistance Program, you will not be eligible for child care under the Individuals and Households Program.

   • The information you have submitted is true and correct. For example, the statement could read: “I declare under penalty of perjury that the information submitted is true and correct.”

Please include your FEMA Application Number and Disaster Number on all pages of your documents. Both numbers are printed at the top of the first page of this letter. Also, you should keep all originals for your records.

Please note, for tax purposes, any disaster assistance awarded for eligible child care expenses shall not be treated as taxable income. However, FEMA assistance awarded to address child care expenses may not be used to take credit for qualifying child care or dependent care expenses under Section 21 of the Internal Revenue Code. For specific questions regarding the preparation of your tax returns, please contact the Internal Revenue Service directly (www.IRS.gov).

Mail your documents to: Fax your documents to:

FEMA - Applicant Services 1-800-827-8112

National Processing Service Center OR Attention: FEMA - Applicant Services

P.O. Box 10055

Hyattsville, MD 20782-8055

Include your FEMA Application Number and Disaster Number on all pages of your documents. Both numbers are printed at the top of the first page of this letter. Keep all originals for your records.

If we do not receive the information within 21 days, we will deny your request for this assistance.

If you have any questions, please call FEMA's Helpline at 1-800-621-FEMA (3362). Disaster assistance applicants, who have a speech disability or hearing loss and use a TTY, call 1-800-462-7585 directly; for those who use 711 or Video Relay Service (VRS), call 1-800-621-3362.

Sincerely,

Individuals and Households Program Officer

Eligibility Criteria for FEMA’s Child Care Disaster Assistance

For your information: In order to be considered for child care assistance, you must meet the following eligibility requirements:

1. General eligibility criteria for the Individuals and Households Program (44 C.F.R. 206.113) have been met and any child care assistance provided to you from FEMA will be used for “expenses incurred as a result of a qualified disaster” pursuant to 26 U.S.C. § 139(b)(1).

2. You cannot make use of child care emergency services provided under FEMA’s Public Assistance Program or other available assistance (e.g., other Federal assistance for child care, private employer child care services, etc.), and you have not received child care compensation from insurance or any other source that meets your current child care needs.

3. You have an increased post-disaster financial burden for child care services: (a) either your child care costs post-disaster are higher than your pre-disaster child care costs as a direct result of the disaster, OR (b) your household income has decreased as a result of the disaster but your child care costs post-disaster remain the same as your pre-disaster child care costs.

4. Your child care provider is an “eligible child care provider.” To be an eligible child care provider, the provider must be licensed, regulated, or registered under State or local law.

5. Child care services are for children age 13 and under or for children ages 14 up to 18 who have a disability, as defined by Federal law, and who are unable to care for themselves.