Disaster Assistance Registration

Documents and Forms

Document Name Document Type
Form FF-104-FY-21-122 ( Disaster Assistance Registration Form
FF-104-FY-21-122 ( Application for Disaster Assistance (paper, English) FEMA Form FF-104-FY-21-122.pdf Form
FF-104-FY-21-122-A Application / Registration for Disaster Assistance (pape FEMA Form FF-104-FY-21-122-A.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Disaster Assistance Registration	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 Subpart D (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FF-104-FY-21-122 (formerly 009-0-1)	Application for Disaster Assistance (paper, English)	FEMA Form FF-104-FY-21-122.pdf		No		Paper Only
Form	FF-104-FY-21-122-A (formerly 009-0-2)	Application / Registration for Disaster Assistance (paper, Spanish)	FEMA Form FF-104-FY-21-122-A.pdf		No		Paper Only

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records
Title: DHS/FEMA 008 Disaster Recovery Assistance Files	FR Citation: 87 FR 7852

Number of Respondents: 2,300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	2,300	2,300
Annual IC Time Burden (Hours)	767	767
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.