OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

5th Batch of Hermit's Peak Instruments (Revised)

IC 271130 under ICR 202404-1660-002 · OMB 1660-0159.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form FEMA Form FF-104-F
Banking Information Form (Spanish) 5th Batch of Hermit's Peak Instruments (Revised)		 Form
Form Form FF-104-FY-22-
Notice of Loss (Spanish) 5th Batch of Hermit's Peak Instruments (Revised)		 Form
Form FEMA Form FF-104-F
Release and Certifications (Entity) - Partial Payment (Spanish) 5th Batch of Hermit's Peak Instruments (Revised)		 Form
Form FEMA Form FF-104-F
Release and Certifications (Individuals and Households) - Partial Payment (Spanish) 5th Batch of Hermit's Peak Instruments (Revised)		 Form
Form FEMA Form FF-104-F
Proof of Loss (Spanish) 5th Batch of Hermit's Peak Instruments (Revised)		 Form
FEMA Form FF-104-F Banking Information Form (Spanish)
FEMA Form FF-104-FY-22-251-A.pdf 		Form
Form FF-104-FY-22- Notice of Loss (Spanish)
FEMA Form FF-104-FY-22-230-A.pdf 		Form
FEMA Form FF-104-F Release and Certifications (Entity) - Partial Payment (S
FEMA Form FF-104-FY-22-253-A.pdf 		Form
FEMA Form FF-104-F Release and Certifications (Individuals and Households)
FEMA Form FF-104-FY-22-252-A.pdf 		Form
FEMA Form FF-104-F Proof of Loss (Spanish)
FEMA Form FF-104-FY-22-231-A.pdf 		Form
1660-0159 Generic Application Banking Info(ESP)-07-2024.pdf
Generic Application-Banking Information Form (Spanish)		IC Document
1660-0159 Generic Application NOL(ESP)-07-2024.pdf
Generic Application- Notice of Loss (Spanish)		IC Document
1660-0159 Generic Application Partial RC (entity)(ESP)07-2024.pdf
Generic Application- Release and Certifications (Entity) - Partial Payment (Spanish)		IC Document
1660-0159 Generic Application Partial RC (I-H)(ESP)07-2024.pdf
Generic Application-Release and Certifications (Individuals and Households) - Partial Payment (Spanish)		IC Document
1660-0159 Generic Application POL (ESP)-07-2024.pdf
Generic Application-Proof of Loss (Spanish)		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 FEMA Form FF-104-FY-22-251-A Yes Yes Fillable Fileable
Form Form FF-104-FY-22-230-A Yes Yes Fillable Fileable
Form FEMA Form FF-104-FY-22-253-A Yes Yes Fillable Fileable
Form FEMA Form FF-104-FY-22-252-A Yes Yes Fillable Fileable
Form FEMA Form FF-104-FY-22-231-A Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 143,625 0 143,625 0 0 0
Annual IC Time Burden (Hours) 691,793 0 691,793 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Generic Application-Banking Information Form (Spanish) 09/24/2024
Generic Application- Notice of Loss (Spanish) 09/24/2024
Generic Application- Release and Certifications (Entity) - Partial Payment (Spanish) 09/24/2024
Generic Application-Release and Certifications (Individuals and Households) - Partial Payment (Spanish) 09/24/2024
Generic Application-Proof of Loss (Spanish) 09/24/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].