Information Collection

Student Stipend Agreement

IC 178877 under ICR 202212-1660-008 · OMB 1660-0100.

Documents and Forms

Documents and forms in this information collection
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

IC Title:

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:

table that charts list of 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 %

table that charts list of burden
	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

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.