Federal Assistance to Individuals and Households Program (IHP)

Forms and Documents

Document Name	Status
Form FEMA Form FF-104-F Autorización para la Divulgación de Información bajo el Acta de Privacidad Form and Instruction	Modified
Form FEMA Form FF-104-F Authorization for the Release of Information Under the Privacy Act Form and Instruction	Modified
Form FEMA Form FF-104-F Solicitud para Detener el Pago y Reemitir el Cheque de Asistencia por Desastre Form and Instruction	Unchanged
Form FEMA Form FF-104-F Request to Stop Payment and Reissue Disaster Assistance Check Form and Instruction	Unchanged
Form FEMA Form FF-104-F Solicitud de Adelanto de la Asistencia por Desastre Form	Unchanged
Form FEMA Form FF-104-F Request for Advance Disaster Assistance Form	Unchanged
Form FEMA Form FF-104-F Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection Form	Unchanged
Form FEMA Form FF-104-F Programa de Individuos y Familias Solicitud para Continuar la Asistencia de Vivienda Temporera Form and Instruction	Unchanged
Form FEMA Form FF-104-F Individual and Households Program Application for Continued Temporary Housing Assistance Form and Instruction	Unchanged
1660-0061 - Change Request for Yup'ik Translation - 2023 12 06.pdf Justification for No Material/Nonsubstantive Change	2023-12-12
1660-0061 - BRI Supporting Statement A - 2023 12 19 clean.docx Supporting Statement A	2023-12-19
1660-0061 - Published 30-Day BRI FRN - 2023 02 27.pdf Supplementary Document	2023-02-27
1660-0061 - Published 60-Day BRI FRN - 2022 12 12.pdf Supplementary Document	2022-12-30
SORN DHS-FEMA-008 - Disaster Recovery Assistance Files (75 FR 25282).pdf Supplementary Document	2022-02-10
privacy-pia-fema-049-ia-january2018.pdf Supplementary Document	2022-02-10
Robert_T_Stafford_Act_Sec_408.pdf Supplementary Document	2013-10-22
44 CFR 206.120.pdf Supplementary Document	2014-04-18
44 CFR 206.115.pdf Supplementary Document	2014-04-18
44 CFR 206.114.pdf Supplementary Document	2014-04-18
44_CFR_206.112.pdf Supplementary Document	2013-10-22
44_CFR_206.110.pdf Supplementary Document	2013-10-22
SRIA copy.pdf Supplementary Document	2013-10-22

IC Document Collections

IC ID	Document Title	Status
242028	Autorización para la Divulgación de Información bajo el Acta de Privacidad Form and Instruction	Modified
242027	Authorization for the Release of Information Under the Privacy Act Form and Instruction	Modified
242024	Solicitud para Detener el Pago y Reemitir el Cheque de Asistencia por Desastre Form and Instruction	Unchanged
242023	Request to Stop Payment and Reissue Disaster Assistance Check Form and Instruction	Unchanged
242022	Solicitud de Adelanto de la Asistencia por Desastre Form	Unchanged
242020	Request for Advance Disaster Assistance Form	Unchanged
21141	Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection Form	Unchanged
204030	Programa de Individuos y Familias Solicitud para Continuar la Asistencia de Vivienda Temporera Form and Instruction	Unchanged
185597	Development of State Administrative Plan for the Other Needs Provison of IHP Other-Regulation	Unchanged
185596	Appeal of Program Decision Other-Regulation	Unchanged
185595	Individual and Households Program Application for Continued Temporary Housing Assistance Form and Instruction	Unchanged
185594	Request for Approval of Late Registration Other-Regulation	Unchanged

ICR Details

OMB Control No: 1660-0061	ICR Reference No: 202312-1660-001
Status: Received in OIRA	Previous ICR Reference No: 202212-1660-013
Agency/Subagency: DHS/FEMA	Agency Tracking No: Yup'ik Change Request
Title: Federal Assistance to Individuals and Households Program (IHP)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/19/2023

	Requested	Previously Approved
Expiration Date	05/31/2026	05/31/2026
Responses	112,163	112,163
Time Burden (Hours)	64,328	64,328
Cost Burden (Dollars)	0	0

---

Abstract: This added instrument is a translation of the current Authorization for the Release of Information under the Privacy Act, FEMA Form FF-104-FY-21-118 (formerly 140-003d-1) into the Yup'ik language stemming from the Presidentially declared disaster, FEMA-4672-DR-AK.

---

Authorizing Statute(s): US Code: 44 USC 206 Name of Law: Federal Disaster Assistance for Disasters Declared on or after November 23 1988
   PL: Pub.L. 106 - 390 408 Name of Law: Robert T Stafford Disaster Relief and Emergency Assistance Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 76064	12/12/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 12397	02/27/2023
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 12

IC Title	Form No.	Form Name
Appeal of Program Decision
Authorization for the Release of Information Under the Privacy Act	FEMA Form FF-104-FY-21-118 (formerly 140-003d-1), FEMA Form FF-104-FY-21-118-B (Yup'ik)	Authorization for the Release of Information Under the Privacy Act ,   Authorization for the Release of Information Under the Privacy Act
Autorización para la Divulgación de Información bajo el Acta de Privacidad	FEMA Form FF-104-FY-21-118-A (formerly 140-003d-1S	Authorization for the Release of Information Under the Privacy Act
Development of State Administrative Plan for the Other Needs Provison of IHP
Individual and Households Program Application for Continued Temporary Housing Assistance	FEMA Form FF-104-FY-21-115 (formerly 010-0-12)	Application for Continued Temporary Housing Assistance (Request for Continued Asisstance)
Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection	FEMA Form FF-104-FY-21-114 (formerly 010-0-11)	Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection
Programa de Individuos y Familias Solicitud para Continuar la Asistencia de Vivienda Temporera	FEMA Form FF-104-FY-21-115-A (formerly 010-0-12S)	Solicitud para Continuar la Asistencia de Vivienda Temporera
Request for Advance Disaster Assistance	FEMA Form FF-104-FY-21-116 (formerly 009-0-95)	Request for Advance Disaster Assistance
Request for Approval of Late Registration
Request to Stop Payment and Reissue Disaster Assistance Check	FEMA Form FF-104-FY-21-117 (formerly 009-0-96)	Request to Stop Payment and Reissue Disaster Assistance Check
Solicitud de Adelanto de la Asistencia por Desastre	FEMA Form FF-104-FY-21-116-A (formerly 009-0-95S)	Solicitud de Adelanto de la Asistencia por Desastre
Solicitud para Detener el Pago y Reemitir el Cheque de Asistencia por Desastre	FEMA Form FF-104-FY-21-117-A (formerly 009-0-96S)	Solicitud para Detener el Pago y Reemitir el Cheque de Asistencia por Desastre

---

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	112,163	112,163	0	0	0	0
Annual Time Burden (Hours)	64,328	64,328	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $1,109,953

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/19/2023

---