Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection

Federal Assistance to Individuals and Households Program (IHP)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0061 can be found here:

Documents and Forms

Document Name Document Type
Form FEMA Form FF-104-F Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection Form
Form FEMA Form FF-104-F Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection Form
FEMA Form FF-104-F Individuals and Households Program (IHP) - Other Needs A FEMA Form FF-104-FY-21-114.pdf Form
FEMA Form FF-104-F Individuals and Households Program (IHP) - Other Needs A FEMA Form FF-104-FY-21-114.pdf Form
FEMA Form FF-104-F Programa de Individuos y Familias Otras Necesidades Asis FEMA Form FF-104-FY-21-114-A_DRAFT.pdf Form and Instruction
FEMA Form FF-104-F Programa de Individuos y Familias Otras Necesidades Asis FEMA Form FF-104-FY-21-114-A_DRAFT.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 44 CFR 206

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FEMA Form FF-104-FY-21-114 (formerly 010-0-11)	Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection	FEMA Form FF-104-FY-21-114.pdf		Yes	No	Fillable Printable
Form and Instruction	FEMA Form FF-104-FY-21-114-A	Programa de Individuos y Familias Otras Necesidades Asistencia Seleccion de Opciones Administrativas	FEMA Form FF-104-FY-21-114-A_DRAFT.pdf		Yes	No	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records
Title: Individuals and Households Program (IHP) Other	FR Citation: 78 FR 25282

Number of Respondents: 629	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	629	629
Annual IC Time Burden (Hours)	692	692
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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