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 (paper, Spanish)	Form	Modified	Repair queued
Form FF-104-FY-21-122 ( Application / Registration for Disaster Assistance (paper, 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	Repair queued
Form FF-104-FY-21-128-A Declaration and Release Form (Spanish)	Form	Modified	Available
Form FF-104-FY-21-128 ( Declaration and Release Form (English)	Form	Modified	Repair queued
Form FF-104-FY-21-128 ( Declaration and Release	Form	Modified	Repair queued
Form FF-104-FY-21-127 ( Temporary Housing Program - Receipt for Government Property (English)	Form	Modified	Available
Form FF-104-FY-21-127-A Temporary Housing Progam-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	Repair queued
Form Self Assessment Qu 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	Repair queued
Form FF-104-FY-21-123-A Tele-Registration Application for Disaster Assistance (Spanish)	Form and Instruction	Modified	Available
Form Assement Questions Assessment Questions	Form and Instruction	Modified	Repair queued
Form FF-104-FY-21-123 ( Tele-Registration Application for Disaster Assistance (English)	Form and Instruction	Modified	Repair queued
Form FF-104-FY-21-123 ( Tele-Registration Application For Disaster Assistance	Form and Instruction	Modified	Repair queued
SORN DHS-FEMA-008 Disaster Recovery Assistance Files (78 FR 25282).pdf	Supplementary Document	Uploaded 2022-01-28	Repair queued
privacy-pia-fema-049-ia-january2018.pdf	Supplementary Document	Uploaded 2022-01-28	Repair queued
1660-0002 - Published 30 Day Renewal FRN 2022 02 22.pdf	Supplementary Document	Uploaded 2022-02-22	Repair queued
1660-0002 - Published 60 Day Renewal FRN Occupany Ownership - 2021 11 05.pdf	Supplementary Document	Uploaded 2022-01-28	Repair queued
OCC and OWN letters mock up Final.docx	Supplementary Document	Uploaded 2021-08-16	Repair queued
1660-0002 - SSA for Funeral Ownership Medical - 2022 02 22 clean.docx	Supporting Statement A	Uploaded 2022-02-22	Repair queued
Stafford Act Booklet 042213, (Sec 408).pdf	Supplementary Document	Uploaded 2021-02-16	Repair queued
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

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
41292	Disaster Assistance Registration	Form	Modified	Application / Registration for Disaster Assistance (paper, Spanish)
41292	Disaster Assistance Registration	Form	Modified	Application / Registration for Disaster Assistance (paper, English)
41292	Disaster Assistance Registration	Form	Modified
251399	Request for Information (RFI) (COVID-19 Funeral Assistance)		New
248900	Request for Information (RFI) Occupancy Verification		Unchanged
248899	Request for Information (RFI) Ownership Verification		Unchanged
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) (Medical, Dental, Disability-Accessibility-Related Items)	Other-Letter	Modified
178884	Declaration and Release	Form	Modified	Declaration and Release Form (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	Temporary Housing Program - Receipt for Government Property (English)
178883	Manufactured Housing Unit Revocable License and Receipt for Government Property	Form	Modified	Temporary Housing Progam-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: 202201-1660-005
Status: Historical Active	Previous ICR Reference No: 202108-1660-004
Agency/Subagency: DHS/FEMA	Agency Tracking No: Revision - Occupancy/Ownership
Title: Disaster Assistance Registration
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: 09/14/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/25/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2025	36 Months From Approved	09/30/2022
Responses	2,043,134	0	2,043,134
Time Burden (Hours)	642,031	0	642,031
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. This extension, without change, will also support the continued ability to provide COVID-19 Funeral Assistance to individuals who are responsible for a deceased individual’s funeral expenses and the expansion of the acceptable documentation applicants can submit to FEMA to verify the occupancy and/or ownership of their primary residence and establish eligibility for disaster assistance.

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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 61283	11/05/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 9634	02/22/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 10

table that charts list of burden

IC Title	Form No.	Form Name
Declaration and Release	FF-104-FY-21-128 (formerly 009-0-3), FF-104-FY-21-128-A (formerly 009-0-4)	Declaration and Release Form (English) ,   Declaration and Release Form (Spanish)
Disaster Assistance Registration	FF-104-FY-21-122-A (formerly 009-0-2), FF-104-FY-21-122 (formerly 009-0-1)	Application / Registration for Disaster Assistance (paper, English) ,   Application / Registration for Disaster Assistance (paper, Spanish)
Internet Application Registration For Disaster Assistance	FF-104-FY-21-125-A (formerly 009-0-1Int), Self Assessment Questions, FF-104-FY-21-125 (formerly 009-0-1Int)	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 (formerly 009-0-6), FF-104-FY-21-127 (formerly 009-0-5)	Temporary Housing Progam-Receipt for Government Property (Spanish) ,   Temporary Housing Program - Receipt for Government Property (English)
Request for Information (RFI) (COVID-19 Funeral Assistance)
Request for Information (RFI) (Medical, Dental, Disability-Accessibility-Related Items)
Request for Information (RFI) Occupancy Verification
Request for Information (RFI) Ownership Verification
Tele-Registration Application For Disaster Assistance	FF-104-FY-21-123 (formerly 009-01T), Assement Questions, FF-104-FY-21-123-A (formerly 009-01T Spanish)	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 (formerly 009-0-1T-COVID	Tele-Registration Application for COVID-19 Funeral Assistance (English)

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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	2,043,134	2,043,134	0	0	0	0
Annual Time Burden (Hours)	642,031	642,031	0	0	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: Miscellaneous Actions

Short Statement: FEMA split one RFI line item in the IC list into two RFI's: the RFI for Medical, Dental, Disability-Accessibility-Related Items, and the RFI for COVID-19 Funeral Assistance. This moved 500,000 respondents from the joint RFI to just the RFI for COVID-19 Funeral Assistance.

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Annual Cost to Federal Government: $283,701,377

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: 02/25/2022

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