FEMA-Administered DCM Intake Form

FEMA-Administered Disaster Case Management (DCM)

Documents and Forms

Document Name Document Type
Form FEMA Form FF-104-F FEMA-Administered DCM Intake Form Form
FEMA Form FF-104-F FEMA-Administered DCM Intake Form FEMA Form FF-104-FY-21-146-DRAFT.pdf Form
FEMA Form FF-104-F FEMA-Administered DCM Intake Form FEMA Form FF-104-FY-21-146-DRAFT.pdf Form

Information Collection (IC) Details

IC Title:	FEMA-Administered DCM Intake Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FEMA Form FF-104-FY-21-146	FEMA-Administered DCM Intake Form	FEMA Form FF-104-FY-21-146-DRAFT.pdf		No		Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 45,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	45,000	45,000
Annual IC Time Burden (Hours)	45,000	45,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.