Request to Stop Payment and Reissue Disaster Assistance Check

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⚠️ Notice: This information collection may be referencing outdated material.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 Request to Stop Payment and Reissue Disaster Assistance Check Form and Instruction
Form FEMA Form FF-104-F Request to Stop Payment and Reissue Disaster Assistance Check Form and Instruction
FEMA Form FF-104-F Request to Stop Payment and Reissue Disaster Assistance FEMA Form FF-104-FY-21-117 (formerly 009-0-96).pdf Form and Instruction
FEMA Form FF-104-F Request to Stop Payment and Reissue Disaster Assistance FEMA Form FF-104-FY-21-117 (formerly 009-0-96).pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Request to Stop Payment and Reissue Disaster Assistance Check	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 44 CFR 206.115

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FEMA Form FF-104-FY-21-117 (formerly 009-0-96)	Request to Stop Payment and Reissue Disaster Assistance Check	FEMA Form FF-104-FY-21-117 (formerly 009-0-96).pdf		No		Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records
Title: DHS/FEMA-008-Disaster Recovery Assistance Files	FR Citation: 78 FR 25282

Number of Respondents: 2,922	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	2,922	2,922
Annual IC Time Burden (Hours)	195	195
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.