FEMA Form FF-104-F Individuals and Households Program (IHP) - Other Needs A

DEPARTMENT OF HOMELAND SECURITY

Federal Emergency Management Agency

OMB Control No. 1660-0061
Expiration Date: 05/31/2026

INDIVIDUALS AND HOUSEHOLDS PROGRAM (IHP)
OTHER NEEDS ASSISTANCE ADMINISTRATIVE OPTION SELECTION
Instructions: This Other Needs Assistance (ONA) Administrative Option Selection Form must be completed and submitted to the
Federal Emergency Management Agency (FEMA) by November 30 of each year. This form may be changed during any nondisaster time period or within three days following a major disaster or emergency declaration.

PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this data collection is estimated to average 1.08 hour per response. The burden estimate includes the
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
submitting this form. This collection of information is required to obtain or retain benefits. You are not required to respond to this
collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the
burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland
Security, Federal Emergency Management Agency, 500 C Street, SW, Washington, DC 20472-3100, Paperwork Reduction Project
(1660-0061). NOTE: Do not send your completed form to this address.

PRIVACY ACT STATEMENT
AUTHORITY: FEMA is authorized to collect the information requested on this form pursuant to Section 696 of the Post-Katrina
Emergency Management Reform Act of 2006 (PKEMRA), 6 U.S.C. 795; The Robert T. Stafford Disaster Relief and Emergency
Assistance Act as amended, 42 U.S.C. §§ 5121-5207 and Reorganization Plan No. 3 of 1978 (43 FR 41943); 44 C.F.R. § 206.2(a)
(27); The Homeland Security Act of 2002, 6 U.S.C. §§ 311-321j; The Personal Responsibility and Work Opportunity Reconciliation
Act of 1996 (Pub. L. 104-193) and Executive Order 12862, Setting Customer Service Standards, dated September 11, 2003 and
Executive Order 13411, Improving Assistance for Disaster Victims, dated August 29, 2006. DHS asks for your SSN pursuant to the
Debt Collection Improvement Act of 1996, 31 U.S.C. § 3325(d) and § 7701(c)(1). SSNs are included on tax returns pursuant to
Internal Revenue Code (various amendments), 26 U.S.C. 6109(d).
PRINCIPAL PURPOSE(S): FEMA collects this information from State/Territorial/Tribal Nation Government to indicate their option
selection every year to administer financial Other Needs Assistance under a Presidentially-declared disaster and identify the limits
for specific items. FEMA will utilize this information internally for quality assurance control purposes.
ROUTINE USE(S): FEMA may share the information collected on this form externally as permitted under 5 U.S.C. § 552a(b) of the
Privacy Act of 1974, as amended. This includes sharing this information with State/Territorial/Tribal Nation Government, and
voluntary organizations to enable individuals to receive additional disaster assistance and as necessary and authorized by other
routine uses published in DHS/FEMA-008 Disaster Recovery Assistance Files System of Records, 87 Fed. Reg. 7852 (Feb. 10,
2022), and upon written request, by agreement, or as required by law.
DISCLOSURE: The disclosure of information on this form is voluntary; however, failure to provide the information requested may
delay or prevent the individual from receiving disaster assistance. If you have any questions about completing this document, you
should call FEMA's Helpline at 1-800-621-FEMA (3362) (hearing/speech impaired only: 1-800-462-7585) as soon as possible.
SUMMARY OF THE ADMINISTRATIVE OPTIONS
FEMA OPTION: Under this option, FEMA administers Other Needs Assistance. The State/Territorial/Tribal Nation Government
coordinates ONA activities with FEMA. FEMA is responsible for functional elements 1 through 10.
JOINT OPTION: Under this option, the State/Territorial/Tribal Nation Government administers Other Needs Assistance. FEMA
participates in providing Other Needs Assistance with the State/Territorial/Tribal Nation Government. FEMA is responsible for
functional elements 1, 2, 3, & 8. The State/Territorial/Tribal Nation Government is responsible for functional elements 4, 5, 6, 7, 9, &
10.
STATE/TERRITORIAL/TRIBAL NATION GOVERNMENT OPTION: Under this option, the State/Territorial/Tribal Nation
Government administers Other Needs Assistance. The State/Territorial/Tribal Nation Government reports Other Needs Assistance
activities to FEMA. The State/Territorial/Tribal Nation Government is responsible for functional elements 1 through 10.

FEMA Form FF-104-FY-21-114 (formerly 010-0-11) (4/24)

Page 1 of 3

DESCRIPTION OF STANDARD PROCESSES
This section explains the 10 standard processes necessary to successfully implement the Other Needs Assistance provision.
1) Registration Intake: the process for receiving applications (Application/Registration for Disaster Assistance FEMA Form 009-0-1)
from disaster survivors who are in need of Federal disaster assistance. The process must be able to receive late applications, up
to the timeframe as described in 44 CFR 206.112.
2) Inspection Services: the process for inspecting, verifying, and recording individually reported disaster-related damages, which
will be used to determine the level of Federal disaster assistance.
3) Processing System: a system designed for making uniformed eligibility determinations, to include methods for determining cost
for personal property and tracking eligibility decisions.
4) Disbursing Awards: a process for issuing funds to applicants.
5) Staffing and Helpline: a process that ensures adequate space and an appropriate number of trained personnel. It also includes
appropriate equipment necessary to process assistance (i.e., computers, phones, and facsimile machines).
6) Recovery of Funds: a process for collecting erroneously awarded funds.
7) Case Processing: a system to process applications and respond to applicant inquiries.
8) Mail Processing: a process for sending program decisions and requests for information and receiving incoming correspondence.
9) Appeal Processing: an official protocol for evaluating an applicant request to have a program decision reviewed.
10) Preparing Closeout: a process that involves the preparation of the narrative and statistical documents that compromise a
model closeout package. The duties of this process include ensuring that there are no cases pending and that all funds are
reconciled for grants and reimbursement of State/Territorial/Tribal Nation government expenses.
Auto-Determination allows the FEMA Processing System business rules to routinely process information received from registrations
and inspections and make an eligibility determination without manual intervention.

STATE/TERRITORIAL/TRIBAL NATION GOVERNMENT SELECTION AND LINE ITEM MAXIMUM
The State/Territorial/Tribal Nation Government of
selects the following administrative option for the
administration of the Other Needs Assistance provision of the Individuals and Households Program:
FEMA Option: FEMA Administers & Processes.
JOINT Option: State/Territorial/Tribal Nation Government Administers & FEMA Participates:
FEMA Processing System Auto-determination ON
FEMA Processing System Auto-determination OFF
STATE/TERRITORIAL/TRIBAL NATION GOVERNMENT Option: State/Territorial/Tribal Nation Government Administers
& Processes. The State/Territorial/Tribal Nation Government approves the following award values and maximum amounts
for specific types of ONA:
The State/Territorial/Tribal Nation Government approves the following line item amounts to be awarded for ONA:
Transportation Repair:
$
Transportation Replace (Total loss) $
Funeral Assistance (Maximum):
$
Per household
Per death
Child Care Assistance (Maximum):
$
Per household
Per child
Displacement Assistance: 14 days @ rate of $
per day
*Rate applies to all declared areas and is based on:
General Services Administration (GSA) standard lodging rate
Lodging rate established by the State/Territorial/Tribal Nation Government
Rate established by the GSA or State/Territorial/Tribal Nation Government for a specific locality in the declared area
(city, town, etc):
The State/Territorial/Tribal Nation Government approves the additional Personal Property and/or Miscellaneous items.
Attached is the list of additional items, the justification, and situations for use.
This administrative option is agreed upon by:
State/Territorial/Tribal Nation Government Authorizing Signature

FEMA Authorizing Signature

Governor/Tribal Chief Executive or Designee

Regional Administrator or Designee

Date

FEMA Form FF-104-FY-21-114 (formerly 010-0-11) (4/24)

Date
Page 2 of 3

ADDITIONAL ONA ITEMS
If the State/Territorial/Tribal Nation Government is requesting additional Personal Property and/or Miscellaneous items, list the items
below and provide the justification and situations for use.
Line Item:

ONA Category:

Standard Quantity:

Maximum Quantity Awarded:

Justification/Situations for Use:

FEMA USE ONLY

Approved

Initial

Not Approved

Initial

Line Item:

ONA Category:

Standard Quantity:

Maximum Quantity Awarded:

Justification/Situations for Use:

FEMA USE ONLY

Approved

Initial

Not Approved

Initial

Line Item:

ONA Category:

Standard Quantity:

Maximum Quantity Awarded:

Justification/Situations for Use:

FEMA USE ONLY

Approved

Initial

Not Approved

Initial

Line Item:

ONA Category:

Standard Quantity:

Maximum Quantity Awarded:

Justification/Situations for Use:

FEMA USE ONLY

Approved

Initial

FEMA Form FF-104-FY-21-114 (formerly 010-0-11) (4/24)

Not Approved

Initial

Page 3 of 3