Information Collection

Student Stipend Agreement (Amendment)

IC 192798 under ICR 202003-1660-003 · OMB 1660-0100.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0100 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FEMA Form 119-25-4 Student Stipend Agreement (Amendment)	Form and Instruction
FEMA Form 119-25-4 Student Stipend Agreement (Amendment) FEMA Form 119-25-4-041717.pdf	Form and Instruction

IC Title:

Student Stipend Agreement (Amendment)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FEMA Form 119-25-4	Student Stipend Agreement (Amendment)	FEMA Form 119-25-4-041717.pdf		No		Fillable Printable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title: Training and Exercise Program Records System

FR Citation: 76 FR 19107

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.