Information Collection

FEMA-Administered DCM Consent Form

IC 250278 under ICR 202111-1660-002 · OMB 1660-0152.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0152 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FEMA Form FF-104-F FEMA-Administered DCM Consent Form	Form
FEMA Form FF-104-F FEMA-Administered DCM Concent Form FEMA Form FF-104-FY-21-147-DRAFT.pdf	Form
FEMA Form FF-104-F FEMA-Administered DCM Concent Form FEMA Form FF-104-FY-21-147-DRAFT.pdf	Form

IC Title:

FEMA-Administered DCM Consent 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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FEMA Form FF-104-FY-21-147	FEMA-Administered DCM Concent Form	FEMA Form FF-104-FY-21-147-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: 30,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30,000	30,000
Annual IC Time Burden (Hours)	3,000	3,000
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.