Information Collection

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

IC 21141 under ICR 202503-1660-004 · OMB 1660-0061.

Documents and Forms

Documents and forms in this information collection
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 Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection	Form
Form FEMA Form FF-104-F Programa de Individuos y Familias Otras Necesidades Asistencia Seleccion de Opciones Administrativas Individuals and Households Program (IHP) - Other Needs Assistance Administrative Option Selection	Form and Instruction
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

IC Title:

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

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-21-114 (formerly 010-0-11)				Yes	No	Fillable Printable
Form and Instruction	FEMA Form FF-104-FY-21-114-A				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 %

table that charts list of burden
	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

table that charts IC Documents
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.

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