OMB control number
Generic Clearance for Notice of Loss and Proof of Loss
OMB 1660-0159 · DHS/FEMA.
OMB 1660-0159
The Federal Emergency Management Agency (FEMA) will use the collected information to commence the process and procedures for claimants to seek compensation for injury or loss of property resulting from the Hermit’s Peak/Calf Canyon Fire and other fires that meet the criteria. Affected state, local and Tribal governments, private sector businesses, not-for-profit organizations, and individuals and households that suffered injuries resulting from fires will be eligible to apply for compensation. Claimants will submit a Notice of Loss to the Agency, meet with a FEMA Claims Reviewer, obtain documentation needed to substantiate claims, sign a Proof of Loss, and complete and return a Release and Certification form.
The latest form for Generic Clearance for Notice of Loss and Proof of Loss expires 2026-11-30 and is listed under ICR 202404-1660-002.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form FEMA Form FF-104-F Third Batch of Hermits Peak Instruments (New) | Form |
| Form FEMA Form FF-104-F Second Batch of Hermits Peak Instruments (Revised) | Form |
| Form FEMA Form FF-104-F Generic Clearance for Notice of Loss and Proof of Loss | Form |
 1660-0159 - Supporting Statement A - 2024 03 29.docx | Supporting Statement A |
| 1660-0159 Signed Change Request - 2024 03 27.pdf | Justification for No Material/Nonsubstantive Change |
| 1660-NW163 - Published 30-Day New Generic FRN - 2023 08 11.pdf | Supplementary Document |
| 1660-NW163 - Published 60-Day New Generic FRN - 2023 05 05.pdf | Supplementary Document |
| PLAW-117publ103.pdf | Supplementary Document |
| USCODE-2021-title42-chap68.pdf | Supplementary Document |
 Third Batch of Hermits Peak Instruments (New) |
Form |
| Second Batch of Hermits Peak Instruments (Revised) |
Form |
| Generic Clearance for Notice of Loss and Proof of Loss |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202404-1660-002 | No material or nonsubstantive change to a currently approved collection | 2024-04-05 | Approved without change | |
| 202403-1660-006 | No material or nonsubstantive change to a currently approved collection | 2024-04-04 | Approved without change | |
| 202305-1660-002 | New collection (Request for a new OMB Control Number) | 2023-08-28 | Approved without change |
OMB Details
Generic Clearance for Notice of Loss and Proof of Loss
Federal Enterprise Architecture: Disaster Management - Disaster Repair and Restore
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form FEMA Form FF-104-FY-22-252-A | #2 Release and Certification (Individual/Household)- Partial Payment (Spanish) | Printable Only | Form |
| Form FEMA Form FF-104-FY-22-251-A | Banking Information Form (Spanish) | Printable Only | Form |
| Form FEMA Form FF-104-FY-22-251 | Banking Information Form (English) | Printable Only | Form |
| Form FEMA Form FF-104-FY-22-254-A | #5 Request to Supplement Claim (Spanish) | Printable Only | Form |
| Form FEMA Form FF-104-FY-22-252 | #2 Release and Certification (Individual/Household)- Partial Payment (English) | Printable Only | Form |
| Form FEMA Form FF-104-FY-22-254 | #5 Request to Supplement Claim (English) | Printable Only | Form |
| Form FEMA Form FF-104-FY-22-230-A | #4 Notice of Loss (Spanish) | Printable Only | Form |
| Form FEMA Form FF-104-FY-22-230 | #4 Notice of Loss (English) | Printable Only | Form |
| Form FEMA Form FF-104-FY-22-253-A | #3 Release and Certification (Entity)- Partial Payment (Spanish) | Printable Only | Form |
| Form FEMA Form FF-104-FY-22-253 | #3 Release and Certification (Entity)- Partial Payment (English) | Printable Only | Form |
| Form FEMA Form FF-104-FY-22-231 | #1 Proof of Loss (English) | Printable Only | Form |
| Form FEMA Forn FF-104-FY-22-231-A | #1 Proof of Loss (Spanish) | Printable Only | Form |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.