Pas

DHS Privacy Office
IHP Callouts/Casework/Auto-Dialers Scripts
Privacy Act Statement/e(3) Notice

Streamline Registration Intake Privacy Act Statement
Pursuant to 5 U.S.C. § 552a(e)(3), this Privacy Act Statement serves to inform you of why DHS
is requesting the information on this form.
AUTHORITY:
FEMA collects, uses, maintains, retrieves, and disseminates the records within this system under
the authority of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (the
Stafford Act), Pub. L. No. 93-288, as amended (42 U.S.C. §§ 5121-5207); 6 U.S.C. §§ 776-77,
795; the Debt Collection Improvement Act of 1996, 31 U.S.C. §§ 3325(d), 7701(c)(1); the
Government Performance and Results Act, Pub. L. No. 103-62, as amended; Reorganization
Plan No. 3 of 1978; Executive Order 13411, “Improving Assistance for Disaster Victims,”
August 29, 2006; and Executive Order 12862 “Setting Customer Service Standards,” September
11, 2003; and Executive Order 13411, Improving Assistance for Disaster Victims, dated August
29, 2006.
PURPOSE:
This information is being collected for the purpose of determining whether applicants have
unmet needs, in order to process the applicant for financial or direct assistance and/or share the
results of those contacts directly with external stakeholders, such as state or local government
partners, who can potentially assist those same applicants with assistance or services not
provided by FEMA through specific programs directly targeted to disaster survivors.
ROUTINE USES:
The information requested through Streamline Registration Intake may be shared externally as a
“routine use” to Federal, State, Tribal, local agencies, and voluntary organizations to assist
FEMA in assisting individuals in receiving additional disaster assistance, to prevent duplicating
of benefits, or for FEMA to recover disaster funds received erroneously, spent inappropriately, or
through fraud. A complete list of the routine uses can be found in the system of records
associated with the collection, “DHS/FEMA-008 Disaster Recovery Assistance Files” and
“DHS/FEMA-017 Individuals and Households Program Equity Analysis Records.” The
Department’s full list of system of records notices can be found on the Department's website at
http://www.dhs.gov/system-records-notices-sorns.
CONSEQUENCES OF FAILURE TO PROVIDE INFORMATION:
Providing this information is voluntary however, failure to provide the information requested
may delay or prevent applicant from receiving disaster-related assistance. Questions regarding
this form may be submitted via email to [email protected] or (866)-562-2379.

PAS/e(3) template
Version 02-2016

Page 1