FEMA Template 104-FY-21-100 Equitable COVID-19 Response and Recovery: Vaccine Administration Information

Public Assistance Program

OMB: 1660-0017

IC ID: 247457

Information Collection (IC) Details

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FEMA Template 104-FY-21-100 Equitable COVID-19 Response and Recovery: Vaccine Administration Information
 
No Modified
 
Required to Obtain or Retain Benefits
 
44 CFR 206

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction FEMA Template 104-FY-21-100 Equitable Vaccine Administration Information Submission fema_public-assistance-covid-19-medical-care-v2-with-equity-job-aid_policy_3-15-2021.pdf https://www.fema.gov/sites/default/files/documents/fema_public-assistance-covid-19-medical-care-v2-with-equity-job-aid_policy_3-15-2021.pdf Yes Yes Fillable Printable

Disaster Management Disaster Repair and Restore

 

56 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 51,016 0 0 0 0 51,016
Annual IC Time Burden (Hours) 25,508 0 0 0 0 25,508
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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