Federal Assistance to Individuals and Households Program (IHP)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FEMA Form 140-003d Authorization for the Release of Information Under the Privacy Act	Form and Instruction	New	Repair queued
Form FEMA Form 140-003d Autorización para la Divulgación de Información bajo el Acta de Privacidad	Form and Instruction	New	Repair queued
Form FEMA Form 140-003d Authorization for the Release of Information Under the Privacy Act	Form and Instruction	New	Repair queued
Form FEMA Form 140-003d Authorization for the Release of Information Under the Privacy Act	Form and Instruction	New	Repair queued
Form FEMA Form 009-0-96 Solicitud para Detener el Pago y Reemitir el Cheque de Asistencia por Desastre	Form and Instruction	New	Repair queued
Form FEMA Form 009-0-96 Solicitud para Detener el Pago y Reemitir el Cheque de Asistencia por Desastre	Form and Instruction	New	Repair queued
Form FEMA Form 009-0-96 Request to Stop Payment and Reissue Disaster Assistance Check	Form and Instruction	New	Repair queued
Form FEMA Form 009-0-96 Request to Stop Payment and Reissue Disaster Assistance Check	Form and Instruction	New	Repair queued
Form FEMA Form 009-0-95 Solicitud de Adelanto de la Asistencia por Desastre	Form	New	Repair queued
Form FEMA Form 009-0-95 Solicitud de Adelanto de la Asistencia por Desastre	Form	New	Repair queued
Form FEMA Form 009-0-95 Request for Advance Disaster Assistance	Form	New	Repair queued
Form FEMA Form 009-0-95 Request for Advance Disaster Assistance	Form	New	Repair queued
Form FEMA Form 009-0-95 Request for Advance Disaster Assistance	Form and Instruction		Repair queued
Form FEMA Form 009-0-95 Solicitud de Adelanto de la Asistencia por Desastre	Form and Instruction		Repair queued
Form FEMA Form 010-0-11 Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection	Form	Modified	Repair queued
Form FEMA Form 010-0-11 Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection	Form	Modified	Repair queued
Form FEMA Form 010-0-12 Solicitud para Continuar la Asistencia de Vivienda Temporera	Form and Instruction	Modified	Available
Form FEMA Form 010-0-12 Programa de Individuos y Familias Solicitud para Continuar la Asistencia de Vivienda Temporera	Form and Instruction	Modified	Repair queued
Form FEMA Form 010-0-12 Application for Continued Temporary Housing Assistance (Request for Continued Asisstance)	Form and Instruction	Modified	Repair queued
Published 30 Day.pdf	Supplementary Document	Uploaded 2020-05-28	Repair queued
Published 60 Day FRN.pdf	Supplementary Document	Uploaded 2020-05-28	Repair queued
NPLATE.RTF	Supplementary Document	Uploaded 2017-11-28	Repair queued
ILATE.RTF	Supplementary Document	Uploaded 2017-11-28	Repair queued
NLATE.RTF	Supplementary Document	Uploaded 2017-11-28	Repair queued
Declaration Package_Region VIII.pdf	Supplementary Document	Uploaded 2017-11-28	Repair queued
Supporting Statement A Final.docx	Supporting Statement A	Uploaded 2020-05-28	Repair queued
Stafford Act Booklet 042213.pdf	Supplementary Document	Uploaded 2014-04-18	Repair queued
Disaster Recovery Assistance Files SORN Final Fed Reg 20130430.pdf	Supplementary Document	Uploaded 2014-05-05	Repair queued
PIA, FEMA-DMARTS, 20130515, FINAL [signed].pdf	Supplementary Document	Uploaded 2014-04-18	Repair queued
Robert_T_Stafford_Act_Sec_408.pdf	Supplementary Document	Uploaded 2013-10-22	Repair queued
44 CFR 206.120.pdf	Supplementary Document	Uploaded 2014-04-18	Repair queued
44 CFR 206.115.pdf	Supplementary Document	Uploaded 2014-04-18	Repair queued
44 CFR 206.114.pdf	Supplementary Document	Uploaded 2014-04-18	Repair queued
44_CFR_206.112.pdf	Supplementary Document	Uploaded 2013-10-22	Repair queued
44_CFR_206.110.pdf	Supplementary Document	Uploaded 2013-10-22	Repair queued
SRIA copy.pdf	Supplementary Document	Uploaded 2013-10-22	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
242028	Autorización para la Divulgación de Información bajo el Acta de Privacidad	Form and Instruction	New	Authorization for the Release of Information Under the Privacy Act
242028	Autorización para la Divulgación de Información bajo el Acta de Privacidad	Form and Instruction	New
242027	Authorization for the Release of Information Under the Privacy Act	Form and Instruction	New	Authorization for the Release of Information Under the Privacy Act
242027	Authorization for the Release of Information Under the Privacy Act	Form and Instruction	New
242024	Solicitud para Detener el Pago y Reemitir el Cheque de Asistencia por Desastre	Form and Instruction	New	Solicitud para Detener el Pago y Reemitir el Cheque de Asistencia por Desastre
242024	Solicitud para Detener el Pago y Reemitir el Cheque de Asistencia por Desastre	Form and Instruction	New
242023	Request to Stop Payment and Reissue Disaster Assistance Check	Form and Instruction	New	Request to Stop Payment and Reissue Disaster Assistance Check
242023	Request to Stop Payment and Reissue Disaster Assistance Check	Form and Instruction	New
242022	Solicitud de Adelanto de la Asistencia por Desastre	Form	New	Solicitud de Adelanto de la Asistencia por Desastre
242022	Solicitud de Adelanto de la Asistencia por Desastre	Form	New
242020	Request for Advance Disaster Assistance	Form	New	Request for Advance Disaster Assistance
242020	Request for Advance Disaster Assistance	Form	New
242019	Solicitud de Adelanto de la Asistencia por Desastre	Form and Instruction		Request for Advance Disaster Assistance
242019	Solicitud de Adelanto de la Asistencia por Desastre	Form and Instruction
21141	Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection	Form	Modified	Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection
21141	Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection	Form	Modified
204030	Programa de Individuos y Familias Solicitud para Continuar la Asistencia de Vivienda Temporera	Form and Instruction	Modified	Solicitud para Continuar la Asistencia de Vivienda Temporera
204030	Programa de Individuos y Familias Solicitud para Continuar la Asistencia de Vivienda Temporera	Form and Instruction	Modified
185597	Development of State Administrative Plan for the Other Needs Provison of IHP	Other-Regulation	Modified
185596	Appeal of Program Decision	Other-Regulation	Modified
185595	Individual and Households Program Application for Continued Temporary Housing Assistance	Form and Instruction	Modified	Application for Continued Temporary Housing Assistance (Request for Continued Asisstance)
185595	Individual and Households Program Application for Continued Temporary Housing Assistance	Other-Regulation	Modified
185594	Request for Approval of Late Registration	Other-Regulation	Modified

ICR Details

OMB Control No: 1660-0061	ICR Reference No: 202005-1660-005
Status: Historical Active	Previous ICR Reference No: 201708-1660-005
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: Federal Assistance to Individuals and Households Program (IHP)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/21/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/31/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2024	36 Months From Approved	01/31/2021
Responses	185,109	0	78,399
Time Burden (Hours)	150,836	0	65,267
Cost Burden (Dollars)	0	0	0

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Abstract: The IHP allows applicants to request approval of late application request continued assistance, and appeal program decisions. It also allows States and FEMA partnerships for disaster assistance delivery via agreements and plans.

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Authorizing Statute(s): US Code: 44 USC 206 Name of Law: Federal Disaster Assistance for Disasters Declared on or after November 23 1988
   PL: Pub.L. 106 - 390 408 Name of Law: Robert T Stafford Disaster Relief and Emergency Assistance Act
  

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:
	85 FR 14212	03/11/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 31196	05/22/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 13

table that charts list of burden

IC Title	Form No.	Form Name
Appeal of Program Decision
Authorization for the Release of Information Under the Privacy Act	FEMA Form 140-003d-1	Authorization for the Release of Information Under the Privacy Act
Autorización para la Divulgación de Información bajo el Acta de Privacidad	FEMA Form 140-003d-1S	Authorization for the Release of Information Under the Privacy Act
Development of State Administrative Plan for the Other Needs Provison of IHP
Individual and Households Program Application for Continued Temporary Housing Assistance	FEMA Form 010-0-12	Application for Continued Temporary Housing Assistance (Request for Continued Asisstance)
Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection	FEMA Form 010-0-11	Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection
Programa de Individuos y Familias Solicitud para Continuar la Asistencia de Vivienda Temporera	FEMA Form 010-0-12S	Solicitud para Continuar la Asistencia de Vivienda Temporera
Request for Advance Disaster Assistance	FEMA Form 009-0-95	Request for Advance Disaster Assistance
Request for Approval of Late Registration
Request to Stop Payment and Reissue Disaster Assistance Check	FEMA Form 009-0-96	Request to Stop Payment and Reissue Disaster Assistance Check
Solicitud de Adelanto de la Asistencia por Desastre	FEMA Form 009-0-95S	Solicitud de Adelanto de la Asistencia por Desastre
Solicitud de Adelanto de la Asistencia por Desastre	FEMA Form 009-0-95	Request for Advance Disaster Assistance
Solicitud para Detener el Pago y Reemitir el Cheque de Asistencia por Desastre	FEMA Form 009-0-96S	Solicitud para Detener el Pago y Reemitir el Cheque de Asistencia por Desastre

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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	185,109	78,399	0	106,710	0	0
Annual Time Burden (Hours)	150,836	65,267	0	85,569	0	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: Changing Forms

Short Statement: This information collection is being revised to include several new forms: FF 009-0-95, FF 009-0-95S, FF 009-0-96, FF 009-0-96S, FF 140-003d-1, and FF 140-003d-1S. The addition of these forms benefits applicants by providing them with streamlined processes for requesting advance disaster assistance, requesting assistance sent by check be stopped and reissued if not received, and to authorize the release of their information to designated third parties. The addition of these new forms, along with updated estimates for the current forms in the collection based off historical data received from FEMA’s Recovery Reporting and Analytics Division (RAD), has led to an overall increase in annual burden hours.

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Annual Cost to Federal Government: $1,089,213

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.     No

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: 05/31/2020

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