Information Collection

CCP/ISP Crisis Counseling Assistance and Training Program, Immediate Services Program Application

IC 21184 under ICR 202211-1660-004 · OMB 1660-0085.

Documents and Forms

Document Name Document Type
Form FEMA Form FF-104-F CCP/ISP Crisis Counseling Assistance and Training Program, Immediate Services Program Application Form and Instruction
FEMA Form FF-104-F CCP/ISP Crisis Counseling Assistance and Training Progra FF-104-FY-21-148 ISP Application 60 adjudication.docx www.samhsa.gov/dtac/ccp-toolkit Form and Instruction
FEMA Form FF-104-F CCP/ISP Crisis Counseling Assistance and Training Progra FF-104-FY-21-148 ISP Application 60 adjudication.docx www.samhsa.gov/dtac/ccp-toolkit Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CCP/ISP Crisis Counseling Assistance and Training Program, Immediate Services Program Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 44 CFR 206.171

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FEMA Form FF-104-FY-21-148 (formerly 003-0-1)	CCP/ISP Crisis Counseling Assistance and Training Program, Immediate Services Program Application	FF-104-FY-21-148 ISP Application 60 adjudication.docx	https://www.samhsa.gov/dtac/ccp-toolkit	Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title: DHS/FEMA-009 â Hazard Mitigation Assistance Grant Programs	FR Citation: 77 FR 17783

Number of Respondents: 18	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	18	3	15
Annual IC Time Burden (Hours)	144	24	120
Annual IC Cost Burden (Dollars)	0	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.