Student Stipend Agreement

General Admissions Application (Long and Short) and Stipend Forms

Documents and Forms

Document Name Document Type
Form FEMA Form FF-USFA- Student Stipend Agreement Form and Instruction
FEMA Form FF-USFA- Studen Stipend Agreement FEMA Form 119-25-3-041717.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Student Stipend Agreement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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 and Instruction	FEMA Form FF-USFA-21-103 (formerly 119-25-3)	Studen Stipend Agreement	FEMA Form 119-25-3-041717.pdf		Yes	Yes	Fillable Printable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title: Training and Exercise Program	FR Citation: 76 FR 19107

Number of Respondents: 7,000	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	7,000	0	7,000
Annual IC Time Burden (Hours)	175	-58	233
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.