General Admissions Application (Long and Short) and Stipend Forms

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FEMA Form 119-25-0 Training Registration Form	Form and Instruction	Modified	Available
Form FEMA Form 119-25-1 General Admissions Application	Form and Instruction	Modified	Available
Form FEMA Form 119-25-4 Student Stipend Agreement (Amendment)	Form and Instruction	Modified	Available
Form FEMA Form 119-25-5 National Fire Academy Executive Fire Officer Program Application for Admission	Form and Instruction	Modified	Available
Form FEMA Form 119-25-3 Studen Stipend Agreement	Form and Instruction	Modified	Available
Table of Changes for FEMA Form 119-25-5.Differences in revised form.EFOP Application.docx	Supplementary Document	Uploaded 2020-04-29	Available
Published 30 Day FRN.pdf	Supplementary Document	Uploaded 2020-03-10	Available
Published 60 Day FRN.pdf	Supplementary Document	Uploaded 2020-03-10	Available
Supporting Statement 1660-0100 Part A FINAL FINAL 04272020.docx	Supporting Statement A	Uploaded 2020-04-28	Available
Public Law 93-498.pdf	Supplementary Document	Uploaded 2013-07-12	Available
PIA 1660-0100 03292012.pdf	Supplementary Document	Uploaded 2013-07-12	Available
SORN 1660-0100 04062011.pdf	Supplementary Document	Uploaded 2013-07-12	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
223957	Training Registration Form	Form and Instruction	Modified	Training Registration Form
21048	General Admissions Application	Form and Instruction	Modified	General Admissions Application
192798	Student Stipend Agreement (Amendment)	Form and Instruction	Modified	Student Stipend Agreement (Amendment)
178881	Executive Fire Officer program Application for Admission	Form and Instruction	Modified	National Fire Academy Executive Fire Officer Program Application for Admission
178877	Student Stipend Agreement	Form and Instruction	Modified	Studen Stipend Agreement

ICR Details

OMB Control No: 1660-0100	ICR Reference No: 202003-1660-003
Status: Historical Active	Previous ICR Reference No: 201610-1660-001
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: General Admissions Application (Long and Short) and Stipend Forms
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/05/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/29/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2023	36 Months From Approved	08/31/2020
Responses	214,300	0	111,800
Time Burden (Hours)	24,400	0	24,400
Cost Burden (Dollars)	0	0	0

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Abstract: FEMA provides training to advance the professional development of personnel engaged in fire prevention and control and emergency management activities through its Center for Domestic Preparedness, Emergency Management Institute, National Fire Academy, National Training and Education Division, National Domestic Preparedness Consortium, and Rural Domestic Preparedness Consortium.

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Authorizing Statute(s): EO: EO 12127 Name/Subject of EO: Federal Emergency Management Agency
   US Code: 42 USC 5121-5207 Name of Law: Robert T. Stafford Disaster Relief and Emergency Assistance Act
   EO: EO 12148 Name/Subject of EO: Federal Emergency Management
  

Citations for New Statutory Requirements: None

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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:
	84 FR 53452	10/07/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 7780	02/11/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Executive Fire Officer program Application for Admission	FEMA Form 119-25-5	National Fire Academy Executive Fire Officer Program Application for Admission
General Admissions Application	FEMA Form 119-25-1	General Admissions Application
Student Stipend Agreement	FEMA Form 119-25-3	Studen Stipend Agreement
Student Stipend Agreement (Amendment)	FEMA Form 119-25-4	Student Stipend Agreement (Amendment)
Training Registration Form	FEMA Form 119-25-0-6	Training Registration Form

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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	214,300	111,800	0	0	102,500	0
Annual Time Burden (Hours)	24,400	24,400	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $274,368

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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)? No

Is this ICR related to the Pandemic Response? No

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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: 04/29/2020

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