Disaster Assistance Registration

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FF-104-FY-21-122-A Application / Registration for Disaster Assistance (Spanish)	Form	Modified	Available
Form FF-104-FY-21-122 Application / Registration for Disaster Assistance (English)	Form	Modified	Available
Form FF-104-FY-21-122 Disaster Assistance Registration	Form	Modified	Repair queued
Form FF-104-FY-21-123-C Tele-Registration Application for COVID-19 Funeral Assistance (English)	Form and Instruction	Modified	Available
Form FF-104-FY-21-123-C Tele-Registration Application for COVID-19 Funeral Assist. (English) FF 009-0-1T-COVID-FA	Form and Instruction	Modified	Missing upstream
Form FF-104-FY-21-128-A Declaration and Release (Spanish)	Form	Modified	Available
Form FF-104-FY-21-128 Declaration and Release Form (English)	Form	Modified	Available
Form FF-104-FY-21-128 Declaration and Release	Form	Modified	Repair queued
Form FF-104-FY-21-127 Manufactured Housing Unit Revocable License and Receipt for Government Property (English)	Form	Modified	Available
Form FF-104-FY-21-127-A Manufactured Housing Unit Revocable License and Receipt for Government Property (Spanish)	Form	Modified	Available
Form FF-104-FY-21-127-A Manufactured Housing Unit Revocable License and Receipt for Government Property	Form	Modified	Missing upstream
Form Assessment Questio Self Assessment Questions	Form and Instruction	Modified	Available
Form FF-104-FY-21-125-A Internet Application Registration For Disaster Assistance (Spanish)	Form and Instruction	Modified	Available
Form FF-104-FY-21-125 Internet Application Registration For Disaster Assistance (English)	Form and Instruction	Modified	Available
Form FF-104-FY-21-125 Internet Application Registration For Disaster Assistance	Form and Instruction	Modified	Missing upstream
Form FF-104-FY-21-123-A Tele-Registration Application for Disaster Assistance (Spanish)	Form and Instruction	Modified	Available
Form Assessment Questio Assessment Questions	Form and Instruction	Modified	Available
Form FF-104-FY-21-123 Tele-Registration Application for Disaster Assistance (English)	Form and Instruction	Modified	Available
Form FF-104-FY-21-123 Tele-Registration Application For Disaster Assistance	Form and Instruction	Modified	Available
1660-0002 Supporting Statement A COVID Funeral 2021 07 22 clean.docx	Supporting Statement A	Uploaded 2021-07-22	Repair queued
SORN DHS-ALL-016 Correspondence Records (83 FR 48645).pdf	Supplementary Document	Uploaded 2021-07-07	Repair queued
SORN DHS-FEMA-008 Disaster Recovery Assistance Files (78 FR 25282).pdf	Supplementary Document	Uploaded 2021-07-07	Repair queued
privacy-pia-fema-049-ia-january2018.pdf	Supplementary Document	Uploaded 2021-07-07	Repair queued
Stafford Act Booklet 042213, (Sec 408).pdf	Supplementary Document	Uploaded 2021-02-16	Missing upstream
SRIA copy.pdf	Supplementary Document	Uploaded 2021-02-16	Repair queued
Personal Responsibility and Work Opportunity Reconciliation.pdf	Supplementary Document	Uploaded 2021-02-16	Available
Title 44 cfr 206.117.pdf	Supplementary Document	Uploaded 2021-02-16	Repair queued
44 CFR sec 206-110.pdf	Supplementary Document	Uploaded 2021-02-16	Repair queued
1660-0002 Published Funeral Renewal 30 Day FRN - 2021 07 22.pdf	Supplementary Document	Uploaded 2021-07-22	Repair queued
1660-0002 Published Funeral Renewal 60 Day FRN - 2021 04 12.pdf	Supplementary Document	Uploaded 2021-07-01	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
41292	Disaster Assistance Registration	Form	Modified	Application / Registration for Disaster Assistance (Spanish)
41292	Disaster Assistance Registration	Form	Modified	Application / Registration for Disaster Assistance (English)
41292	Disaster Assistance Registration	Form	Modified
246283	Tele-Registration Application for COVID-19 Funeral Assist. (English) FF 009-0-1T-COVID-FA	Form and Instruction	Modified	Tele-Registration Application for COVID-19 Funeral Assistance (English)
246283	Tele-Registration Application for COVID-19 Funeral Assist. (English) FF 009-0-1T-COVID-FA	Form and Instruction	Modified
208764	Request for Information (RFI) Letter	Other-Letter	Unchanged
178884	Declaration and Release	Form	Modified	Declaration and Release (Spanish)
178884	Declaration and Release	Form	Modified	Declaration and Release Form (English)
178884	Declaration and Release	Form	Modified
178883	Manufactured Housing Unit Revocable License and Receipt for Government Property	Form	Modified	Manufactured Housing Unit Revocable License and Receipt for Government Property (English)
178883	Manufactured Housing Unit Revocable License and Receipt for Government Property	Form	Modified	Manufactured Housing Unit Revocable License and Receipt for Government Property (Spanish)
178883	Manufactured Housing Unit Revocable License and Receipt for Government Property	Form	Modified
178839	Internet Application Registration For Disaster Assistance	Form and Instruction	Modified	Self Assessment Questions
178839	Internet Application Registration For Disaster Assistance	Form and Instruction	Modified	Internet Application Registration For Disaster Assistance (Spanish)
178839	Internet Application Registration For Disaster Assistance	Form and Instruction	Modified	Internet Application Registration For Disaster Assistance (English)
178839	Internet Application Registration For Disaster Assistance	Form and Instruction	Modified
178838	Tele-Registration Application For Disaster Assistance	Form and Instruction	Modified	Tele-Registration Application for Disaster Assistance (Spanish)
178838	Tele-Registration Application For Disaster Assistance	Form and Instruction	Modified	Assessment Questions
178838	Tele-Registration Application For Disaster Assistance	Form and Instruction	Modified	Tele-Registration Application for Disaster Assistance (English)
178838	Tele-Registration Application For Disaster Assistance	Form and Instruction	Modified

ICR Details

OMB Control No: 1660-0002	ICR Reference No: 202107-1660-002
Status: Historical Inactive	Previous ICR Reference No: 202103-1660-006
Agency/Subagency: DHS/FEMA	Agency Tracking No: Renewal After Emergency
Title: Disaster Assistance Registration
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 08/16/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/03/2021
Terms of Clearance: Withdrawn at DHS request in order to submit an emergency revision for a separate change.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2021	36 Months From Approved	09/30/2021
Responses	2,004,488	0	2,004,488
Time Burden (Hours)	622,707	0	622,707
Cost Burden (Dollars)	0	0	0

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Abstract: The forms in this collection are used to obtain pertinent information to provide financial assistance, and if necessary, direct assistance to eligible individuals and households who, as a direct result of a disaster or emergency, have uninsured or under-insured, necessary or serious expenses they are unable to meet. To provide meaningful access to individuals with disabilities throughout FEMA programs, the revision to the collection will obtain pertinent disability-related information.

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Authorizing Statute(s): US Code: 8 USC 1601 Name of Law: Personnel Responsibility and Work Opportunity Reconciliation Act of 1996
   US Code: 42 USC 5174 Name of Law: Disaster Mitigation Act of 2000
   PL: Pub.L. 93 - 288 0000 Name of Law: Robert T. Stafford Disaster Relief and Emergency Assistance Act
   PL: Pub.L. 116 - 260 133 Name of Law: Consolidated Appropriations Act, of 2021
  

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:
	86 FR 19001	04/12/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 38730	07/22/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Declaration and Release	FF-104-FY-21-128, FF-104-FY-21-128-A	Declaration and Release Form (English) ,   Declaration and Release (Spanish)
Disaster Assistance Registration	FF-104-FY-21-122, FF-104-FY-21-122-A	Application / Registration for Disaster Assistance (English) ,   Application / Registration for Disaster Assistance (Spanish)
Internet Application Registration For Disaster Assistance	FF-104-FY-21-125-A, Assessment Questions, FF-104-FY-21-125	Internet Application Registration For Disaster Assistance (English) ,   Internet Application Registration For Disaster Assistance (Spanish) ,   Self Assessment Questions
Manufactured Housing Unit Revocable License and Receipt for Government Property	FF-104-FY-21-127-A, FF-104-FY-21-127	Manufactured Housing Unit Revocable License and Receipt for Government Property (Spanish) ,   Manufactured Housing Unit Revocable License and Receipt for Government Property (English)
Request for Information (RFI) Letter
Tele-Registration Application For Disaster Assistance	FF-104-FY-21-123, Assessment Questions, FF-104-FY-21-123-A	Tele-Registration Application for Disaster Assistance (English) ,   Assessment Questions ,   Tele-Registration Application for Disaster Assistance (Spanish)
Tele-Registration Application for COVID-19 Funeral Assist. (English) FF 009-0-1T-COVID-FA	FF-104-FY-21-123-COVID-FA	Tele-Registration Application for COVID-19 Funeral Assistance (English)

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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: $203,187,715

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? Yes

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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: 08/03/2021

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