Public Assistance Program

ICR 202212-1660-015

OMB: 1660-0017

Federal Form Document

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1660-0017 can be found here:

Forms and Documents

Document Name	Status
Form FEMA Form FF-104-F Request for Public Assistance Form and Instruction	Modified
Form FEMA Form FF-104-F Tribe Administrative Plan Form and Instruction	New
Form FEMA Form FF-104-F Time Extension Request Form and Instruction	New
Form FEMA Form FF-104-F Damage Information Form and Instruction	New
Form FEMA Form FF-104-F Project Application for Management Costs Form and Instruction	New
Form FEMA Form FF-104-F Project Application for Building Code and Floodplain Management and Enforcement Form and Instruction	New
Form FEMA Form FF-104-F Project Application for Infrastructure Restoration Form and Instruction	New
Form FEMA Form FF-104-F Project Application for COVID-19 Form and Instruction	New
Form FEMA Form FF-104-F Project Application for Emergency Protective Measures Form and Instruction	New
Form FEMA Form FF-104-F Project Application for Debris Removal Form and Instruction	New
Form FEMA Form FF-104-F Pre-Approval Request Form and Instruction	New
Form FEMA Form FF-104-F Donated Labor Sign-in Form and Instruction	New
Form FEMA Form FF-104-F Impact List Form and Instruction	New
Form FEMA Form FF-104-F Applicant Impact Survey Form and Instruction	New
Form FEMA Form FF-104-F Recipient Incident Information Form and Instruction	New
Form FEMA Form FF-104-F Organization Profile Form and Instruction	New
Form FEMA Template 104- Equitable Vaccine Administration Information Submission Template Form and Instruction	Modified
Form 009-0-141 FAC-TRAX System Form	Removed
Form FEMA Form 009-0-91 Project Worksheet Photo Sheet Form	Removed
Form FEMA Form 009-0-91 Project Worksheet Maps and Sketches Sheet Form	Removed
Form FEMA Form 009-0-91 Project Worksheet Cost Estimate Continuation Sheet and Cost Overruns Form	Removed
Form FEMA Form 009-0-91 Project Work Sheet Damage Description and Scope of Work Form	Removed
Form FEMA Form FF-104-F State Administrative Plan Form and Instruction	Modified
Form FEMA Form FF-104-F Force Account Equipment Summary Form and Instruction	Modified
Form FEMA Form FF-104-F Contract Work Summary Form and Instruction	Modified
Form FEMA Form FF-104-F Rented Equipment Summary Form and Instruction	Modified
Form FEMA Form FF-104-F Materials Summary Form and Instruction	Modified
Form FEMA Form FF-104-F Force Account Labor Summary Record Form and Instruction	Modified
Form FEMA Form 009-0-12 PNP Facility Questionnaire Form	Removed
Form FEMA Form FF-104-F Applicant's Benefits Calculation Worksheet Form and Instruction	Modified
Form FEMA Form 009-0-12 Special Considerations Questions Form	Removed
Form FEMA Form 009-0-91 Project Worksheet Form and Instruction	Removed
Form FEMA Form FF-104-F Quarterly Progress Report Form and Instruction	Modified
FF-104-FY-22-247_Hazard Mitigation Addendum_Final.docx Supplementary Document	2023-03-09
FF-104-FY-22-246_Environmental and Historic Preservation Info_Final.docx Supplementary Document	2023-03-09
20160825 FEMA FACTRAX Screenshots.pdf Supplementary Document	2023-03-09
1600-0017 - Published 30-Day BRI FRN - 2023 03 03.pdf Supplementary Document	2023-03-03
1600-0017 - Published 60-Day BRI FRN - 2022 12 14.pdf Supplementary Document	2022-12-30
privacy-pia-fema-hmgp.pdf Supplementary Document	2022-12-30
privacy_pia_FEMA_GrantManagementPrograms_February2015.pdf Supplementary Document	2022-12-30
SORN, DHS-FEMA-009 HMA, PA, and CDL SORN (78 FR 16015, 2014 03 24).pdf Supplementary Document	2022-12-30
1660-0017 - BRI Supporting Statement A - 2023 03 09 clean.docx Supporting Statement A	2023-03-09
stafford_act.pdf Supplementary Document	2016-09-02
CFR-2011-title44-vol1-part206.pdf Supplementary Document	2016-09-01

IC Document Collections

IC ID	Document Title	Status
41294	Request for Public Assistance Form and Instruction	Modified
257686	Tribe Administrative Plan Form and Instruction	New
257685	Time Extension Request Form and Instruction	New
257682	Damage Information Form and Instruction	New
257681	Project Application for Management Costs Form and Instruction	New
257680	Project Application for Building Code and Floodplain Management and Enforcement Form and Instruction	New
257679	Project Application for Infrastructure Restoration Form and Instruction	New
257678	Project Application for COVID-19 Form and Instruction	New
257677	Project Application for Emergency Protective Measures Form and Instruction	New
257676	Project Application for Debris Removal Form and Instruction	New
257675	Pre-Approval Request Form and Instruction	New
257674	Donated Labor Sign-in Form and Instruction	New
257673	Impact List Form and Instruction	New
257672	Applicant Impact Survey Form and Instruction	New
257671	Recipient Incident Information Form and Instruction	New
257670	Organization Profile Form and Instruction	New
247457	Equitable Vaccine Administration Information Submission Template Form and Instruction	Modified
223320	FAC-TRAX System Form	Removed
206469	Project Worksheet Photo Sheet Form	Removed
206468	Project Worksheet Maps and Sketches Sheet Form	Removed
206467	Project Worksheet Cost Estimate Continuation Sheet and Cost Overruns Form	Removed
206466	Project Work Sheet Damage Description and Scope of Work Form	Removed
191941	State Administrative Plan Form and Instruction	Modified
190424	Request for Arbitration and Recommendation from Hurricanes Katrina or Rita	Unchanged
190419	Request for Appeals and Recommendation	Unchanged
185911	Force Account Equipment Summary Form and Instruction	Modified
185910	Contract Work Summary Form and Instruction	Modified
185909	Rented Equipment Summary Form and Instruction	Modified
185908	Materials Summary Form and Instruction	Modified
185907	Force Account Labor Summary Record Form and Instruction	Modified
185906	PNP Facility Questionnaire Form	Removed
185903	Applicant's Benefits Calculation Worksheet Form and Instruction	Modified
185901	Special Considerations Questions Form	Removed
185900	Project Worksheet Form and Instruction	Removed
185897	Quarterly Progress Report Form and Instruction	Modified

ICR Details