Emergency Justification Memo

Emergency Approval for New Collection 1660-NW162 – Notice of Loss and Proof of Loss

U.S. Department of Homeland Security
Washington, D.C. 20472

February 8, 2023
MEMORANDUM FOR:

The Honorable Dominic Mancini
Deputy Administrator
Office of Information and Regulatory Affairs
Office of Management and Budget

THROUGH:

Eric Hysen
Chief Information Officer
Department of Homeland Security

FROM:

Alexandra Travis
Chief Administrative Officer
Mission Support
Federal Emergency Management Agency

SUBJECT:

(1) FEMA Form FF-104-FY-22-230/ FF-104-FY-22-230-A , Notice of Loss/
Notice of Loss (Spanish Translation); (2) FEMA Form FF-104-FY-22-231/
FF-104-FY-22-231-A, Proof of Loss/ Proof of Loss (Spanish Translation); (3)
FEMA Form FF-104-FY-22-252/ FF-104-FY-22-252-A, Release and
Certification Form (Partial Payment)/ Release and Certification Form (Partial
Payment) (Spanish Translation); (4) FEMA Form FF-104-FY-22-253 / FF104-FY-22-253-A, Release and Certification Form Entity (Partial Payment)/
Release and Certification Form Entity (Partial Payment) (Spanish Translation);
(5) FEMA Form FF-104-FY-22-254/ FF-104-FY-22-254-A, Request to
Supplement Claim/ Request to Supplement Claim (Spanish Translation); (6)
FEMA Form FF-104-FY-22-251/ FF-104-FY-22-251-A, Banking
Information/Banking Information (Spanish Translation)

ERIC N HYSEN

Digitally signed by ERIC N
HYSEN
Date: 2023.02.13 12:25:14
-05'00'

Digitally signed by ALEXANDRA
TRAVIS
Date: 2023.02.09 13:49:35 -05'00'

The Federal Emergency Management Agency (FEMA) seeks to utilize the emergency process for
approval for a new information collection to the Office of Management and Budget (OMB) Collection
1660-NW162 Notice of Loss in accordance with the Hermit’s Peak/Calf Canyon Fire Assistance Act
(Pub. L. No. 177-180, 136 Stat. 2114 (2022)) (“Act”). In addition to this emergency approval, the
program will also complete the generic collection review process and post the 60-Day and 30-Day
Federal Register Notices following the Emergency Federal Register Notice.
This information is necessary to support the Act implemented by the Hermit’s Peak/Calf Canyon Fire
Assistance regulation (44 CFR part 296) which was added by FEMA’s November 10, 2022, Hermit’s
Peak/Calf Canyon Fire Assistance Interim Final Rule (RIN 1660-AB14). The purpose of this
authority is to ensure the expeditious consideration and settlement of claims to compensate victims of
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Emergency Approval for New Collection 1660-NW162 – Notice of Loss and Proof of Loss
the Hermit’s Peak/Calf Canyon Fires.
The Hermit’s Peak Fire began on April 6, 2022, after a prescribed burn exceeded the containment
capabilities of the U.S. Forest Service and was declared a wildfire. On April 19, the Calf Canyon
Fire began burning on Federal land and was later identified as the result of a pile burn in January
2022 that remained dormant under the surface before reemerging. The Hermit’s Peak and Calf
Canyon Fires merged on April 27, 2022. By May 2, 2022, the fire had grown, causing evacuations
in multiple villages and communities. On May 4, 2022, President Biden issued a major disaster
declaration for the counties of Colfax, Mora, and San Miguel, New Mexico. The U.S. Forest Service
has assumed responsibility for the Hermit’s Peak/Calf Canyon Fire, which was not 100 percent
contained until August 21, 2022. On September 30, 2022, Congress passed the Act authorizing
FEMA to establish a claims process for victims of the Hermit’s Peak/Calf Canyon Fire.
Congress tasked FEMA with providing expeditious consideration and settlement of claims for injuries
as a result of the Hermit’s Peak/Calf Canyon Fire. In doing so, Congress set strict deadlines around the
claims process. First, FEMA is required to publish interim regulations establishing the process by
November 14, 2022. Once the process is established in regulation, Claimants will have two years from
the date the regulation is published to submit their Notice of Loss to FEMA. The Notice of Loss
provides confirmation that the Claimant has elected to use the process under the Act to seek
compensation for injuries resulting from the Hermit’s Peak/Calf Canyon Fires and formally begins the
claims process. Without immediate access to the Notice of Loss, Claimants will not have the full
period of time available under the statute to submit their claim.
Following the normal clearance procedures for approval, this information collection will delay
FEMA’s ability to expeditiously consider and settle claims arising from injuries as a result of the
Hermit’s Peak/Calf Canyon Fire. The victims of this Fire deserve compensation for their injuries and
Congress has demanded immediate action to compensate them.
It is vital that FEMA implement the information collection as soon as possible to support immediate
needs in response to the Hermit’s Peak/Calf Canyon Fire. In accordance with the Paperwork
Reduction Act (PRA) and the Office of Management and Budget’s (OMB) implementing regulations
at 5 C.F.R. § 1320.13: (1) this information is necessary to the mission of the agency, (2) this
information is necessary prior to the expiration of time periods established under PRA, (3) public
harm is reasonably likely to result if normal clearance procedures are followed, and (4) an
unanticipated event has occurred.
1. Information is Essential to the Mission of the Agency
This information is necessary to compensate victims of the Hermit’s Peak/Calf Canyon Fire for
injuries resulting from the Fire. The purpose of this authority is to ensure the expeditious
consideration and settlement of claims for those injuries pursuant to the Act. The Hermit’s Peak/Calf
Canyon Fire is the largest wildfires in New Mexico history, destroying at least 160 homes and over
900 structures and burning over 340,000 acres of forest including just under 200,000 total acres of
privately-owned land. Despite containment, the impact of the Fire continues to be felt in the impacted
areas, causing flooding and setting off a drinking water crisis.
Because the U.S. Forest Service assumed responsibility for the fires and Congress authorized $3.9
billion in funding to support the expeditious consideration and settlement of claims for those injured by
the Fires, FEMA requests an emergency approval to collect the necessary information from claimants to
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Emergency Approval for New Collection 1660-NW162 – Notice of Loss and Proof of Loss
begin the claims process.
Recognizing the need to move forward quickly, Congress authorized FEMA to publish an interim
final rule by November 14, 2022, for the processing and payment of claims under the Act. To ensure
FEMA is able to begin processing claims upon publication of the interim final rule, the agency must
have a mechanism for claimants to provide information on their injuries. The Notice of Loss form
serves to structure the information concerning the injuries sustained by claimants and formally begins
the claims process. Each item of information requested is needed to establish the nature and scope of
the claimant’s injuries and assign a Claims Reviewer to begin review of the claim, while also
ensuring election of the Act’s process for compensation. The information requested includes
Claimant information (name, contact information including phone number, email address, and
physical address); type of claim (individual/household, business, government, Indian Tribe, nonprofit, other); description of losses in general terms (loss of property, business loss, financial loss);
insurance information (company name, whether a claim has been filed with the company); FEMA
grants received; other government assistance (Federal, State, local, Tribal); special needs assistance;
translation assistance; and an attestation choosing the Act’s process as the method of resolving claims
against the Federal government. Additionally, the Release and Certification form (Entity &
Households) are for the advancement of partial payment to disadvantaged claimants. The Release
and Certification (Partial Payment) forms serves to expedite payments where it is appropriate, while
informing the entity/claimant that partial payment cannot be appealed, and acceptance of a partial
payment does not affect the claimant’s ability to pursue an appeal, arbitration, or other options under
the Act. The information requested includes Claimant information (name, contact information
including phone number, social security number, current and damaged property address, and optional
email address).
2. The Information is needed Prior to Expiration of Time Periods Established under PRA
Congress tasked FEMA with providing expeditious consideration and settlement of claims for
injuries as a result of the Hermit’s Peak/Calf Canyon Fires. In doing so, Congress set strict
deadlines around the claims process. First, FEMA is required to publish interim regulations
establishing the process by November 14, 2022. Once the process is established in regulation,
Claimants will have two years from the date the regulation is published to submit their Notice of
Loss to FEMA. Without immediate access to the Notice of Loss, Claimants will not have the full
period of time available under the statute to submit their claim. Under the standard time frames put
forward by PRA a generic collection approval would be around July or August 2023. It would thus
be impracticable and contrary to the public interest to delay implementing this information
collection until after FEMA has completed the PRA process.
3. Public Harm is Reasonably Likely to Result if Normal Clearance Procedures are Followed
Public harm is reasonably likely to result if normal clearance procedures are followed because it may
lead to delays in Claimants receiving compensation for injuries resulting from the Fires. Furthermore,
leaving HPCO unable to adequately assess claims or perform statutory obligation to administer the
program.
4. An Unanticipated Event Has Occurred
The Hermit’s Peak Fire began on April 6, 2022, after a prescribed burn exceeded the containment
capabilities of the U.S. Forest Service and was declared a wildfire. On April 19, the Calf Canyon
Fire began burning on Federal land and was later identified as the result of a pile burn in January
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Emergency Approval for New Collection 1660-NW162 – Notice of Loss and Proof of Loss
2022 that remained dormant under the surface before reemerging. The Hermit’s Peak and Calf
Canyon Fires merged on April 27, 2022. By May 2, 2022, the fire had grown, causing evacuations
in multiple villages and communities. President Biden issued a major disaster declaration for the
counties of Colfax, Mora, and San Miguel, New Mexico on May 4, 2022. The U.S. Forest Service
has assumed responsibility for the Hermit’s Peak/Calf Canyon Fire, which was not 100 percent
contained until August 21, 2022. On September 30, 2022, Congress passed the Act authorizing
FEMA to establish a claims process for victims of the Hermit’s Peak/Calf Canyon Fire.
FEMA is requesting emergency approval of this information collection request so that it can accept
claims immediately, process claims, and advance payment to those impoverished by the Hermit’s
Peak/Calf Canyon Fire. Delay in approval of this information collections will disrupt FEMA’s ability
to comply with other provisions of the law and its overall mission.
5. Conclusion
Following the normal clearance procedures for approval this information collection will delay
FEMA’s ability to expeditiously consider and settle claims arising from injuries as a result of the
Hermit’s Peak/Calf Canyon Fire. The victims of these fires deserve compensation for their injuries
and Congress has demanded immediate action to compensate them. As discussed, FEMA certifies
that the requirements of 5 CFR 1320.13(a) are met and it is vital this new collection be implemented
immediately, because: (1) this information is necessary to the mission of the agency, (2) this
information is necessary prior to the expiration of time periods established under PRA, (3) public
harm is reasonably likely to result if normal clearance procedures are followed, and (3) an
unanticipated event has occurred.
Thank you for your consideration.

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