Third Batch of Hermits Peak Instruments (New)

Generic Clearance for Notice of Loss and Proof of Loss

Documents and Forms

Document Name Document Type
Form FEMA Form FF-104-F Third Batch of Hermits Peak Instruments (New) Form
FEMA Form FF-104-F Evacuation Information Worksheet FEMA Form FF-104-FY-24-114_DRAFT.pdf Form
FEMA Form FF-104-F Evacuee Hosting FEMA Form FF-104-FY-24-115_DRAFT.pdf Form
FEMA Form FF-104-F Flood Insurance Assessment FEMA Form FF-104-FY-24-116_DRAFT.pdf Form
FEMA Form FF-104-F Smoke & Ash Cleaning FEMA Form FF-104-FY-24-117_DRAFT.pdf Form
FEMA Form FF-104-F Risk Reduction Proposal FEMA Form FF-104-FY-24-121_DRAFT.pdf Form
1660-0159 Generic Application Evacuation Information-04-2024.docx Generic Application - Evacuation Information IC Document
1660-0159 Generic Application Evacuee Hosting-04-2024.docx Generic Application - Evacuee Hosting IC Document
1660-0159 Generic Application Flood Insur Assess-04-2024.docx Generic Application - Flood Insurance Assessment IC Document
1660-0159 Generic Application Smoke Ash-04-2024.docx Generic Application - Smoke & Ash Cleaning IC Document
1660-0159 Generic Application Risk Reduction-04-2024_Signed.docx Generic Application - Risk Reduction Proposal IC Document
1660-0159 - Burden and Opportunity Costs for 3rd Batch BMOPRA-1112.xlsx Worksheet - Burden and Opportunity Costs IC Document

Information Collection (IC) Details

IC Title:	Third Batch of Hermits Peak Instruments (New)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FEMA Form FF-104-FY-24-114	Evacuation Information Worksheet	FEMA Form FF-104-FY-24-114_DRAFT.pdf	Yes	Yes	Fillable Fileable
Form	FEMA Form FF-104-FY-24-115	Evacuee Hosting	FEMA Form FF-104-FY-24-115_DRAFT.pdf	Yes	Yes	Fillable Fileable
Form	FEMA Form FF-104-FY-24-116	Flood Insurance Assessment	FEMA Form FF-104-FY-24-116_DRAFT.pdf	Yes	Yes	Fillable Fileable
Form	FEMA Form FF-104-FY-24-117	Smoke & Ash Cleaning	FEMA Form FF-104-FY-24-117_DRAFT.pdf	Yes	Yes	Fillable Fileable
Form	FEMA Form FF-104-FY-24-121	Risk Reduction Proposal	FEMA Form FF-104-FY-24-121_DRAFT.pdf	No		Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 105,133	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	105,133	105,133
Annual IC Time Burden (Hours)	91,634	91,634
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Application - Evacuation Information	1660-0159 Generic Application Evacuation Information-04-2024.docx	04/09/2024
Generic Application - Evacuee Hosting	1660-0159 Generic Application Evacuee Hosting-04-2024.docx	04/09/2024
Generic Application - Flood Insurance Assessment	1660-0159 Generic Application Flood Insur Assess-04-2024.docx	04/09/2024
Generic Application - Smoke & Ash Cleaning	1660-0159 Generic Application Smoke Ash-04-2024.docx	04/09/2024
Generic Application - Risk Reduction Proposal	1660-0159 Generic Application Risk Reduction-04-2024_Signed.docx	04/09/2024
Worksheet - Burden and Opportunity Costs	1660-0159 - Burden and Opportunity Costs for 3rd Batch BMOPRA-1112.xlsx	04/09/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.