Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Applicant Impact Survey New 60000 7002 0 Form and Instruction FEMA Form FF-104-FY-22-235
Applicant's Benefits Calculation Worksheet Modified 1920 960 0 Form and Instruction FEMA Form FF-104-FY-21-135 (formerly 009-0-128)
Contract Work Summary Modified 6000 1100 0 Form and Instruction FEMA Form FF-104-FY-21-140 (formerly 009-0-126)
Damage Information New 72000 90000 0 Form and Instruction FEMA Form FF-104-FY-22-245
Donated Labor Sign-in New 600 40 0 Form and Instruction FEMA Form FF-104-FY-22-237
Equitable Vaccine Administration Information Submission Template Modified 13680 6840 0 Form and Instruction FEMA Template 104-FY-21-100
FAC-TRAX System Removed 0 0 0 Form 009-0-141
Force Account Equipment Summary Modified 1920 480 0 Form and Instruction FEMA Form FF-104-FY-21-141 (formerly 009-0-127)
Force Account Labor Summary Record Modified 1920 960 0 Form and Instruction FEMA Form FF-104-FY-21-137 (formerly 009-0-123)
Impact List New 60000 30000 0 Form and Instruction FEMA Form FF-104-FY-22-236
Materials Summary Modified 1920 480 0 Form and Instruction FEMA Form FF-104-FY-21-138 (formerly 009-0-124)
Organization Profile New 60000 18000 0 Form and Instruction FEMA Form FF-104-FY-22-233
PNP Facility Questionnaire Removed 0 0 0 Form FEMA Form 009-0-121
Instruction
Pre-Approval Request New 30000 15000 0 Form and Instruction FEMA Form FF-104-FY-22-238
Project Application for Building Code and Floodplain Management and Enforcement New 300 70 0 Form and Instruction FEMA Form FF-104-FY-22-243
Project Application for COVID-19 New 3000 1100 0 Form and Instruction FEMA Form FF-104-FY-22-241
Project Application for Debris Removal New 60000 45000 0 Form and Instruction FEMA Form FF-104-FY-22-239
Project Application for Emergency Protective Measures New 60000 45000 0 Form and Instruction FEMA Form FF-104-FY-22-240
Project Application for Infrastructure Restoration New 72000 54000 0 Form and Instruction FEMA Form FF-104-FY-22-242
Project Application for Management Costs New 60000 13002 0 Form and Instruction FEMA Form FF-104-FY-22-244
Project Work Sheet Damage Description and Scope of Work Removed 0 0 0 Form FEMA Form 009-0-91A
Project Worksheet Removed 0 0 0 Form and Instruction FEMA Form 009-0-91
Project Worksheet Cost Estimate Continuation Sheet and Cost Overruns Removed 0 0 0 Form FEMA Form 009-0-91B
Project Worksheet Maps and Sketches Sheet Removed 0 0 0 Form FEMA Form 009-0-91C
Project Worksheet Photo Sheet Removed 0 0 0 Form FEMA Form 009-0-91D
Quarterly Progress Report Modified 240 144 0 Form and Instruction FEMA Form FF-104-FY-21-132 (formerly 009-0-111)
Recipient Incident Information New 60 5 0 Form and Instruction FEMA Form FF-104-FY-22-234
Rented Equipment Summary Modified 1920 960 0 Form and Instruction FEMA Form FF-104-FY-21-139 (formerly 009-0-125)
Request for Appeals and Recommendation Unchanged 504 1512 0
Request for Arbitration and Recommendation from Hurricanes Katrina or Rita Unchanged 20 60 0
Request for Public Assistance Modified 60000 7002 0 Form and Instruction FEMA Form FF-104-FY-21-131 (formerly 009-0-49)
Special Considerations Questions Removed 0 0 0 Form FEMA Form 009-0-120
State Administrative Plan Modified 60 36 0 Form and Instruction FEMA Form FF-104-FY-22-249
Time Extension Request New 7200 2880 0 Form and Instruction FEMA Form FF-104-FY-22-248
Tribe Administrative Plan New 5 2 0 Form and Instruction FEMA Form FF-104-FY-22-250
Total burden requested under this ICR: 635269 341635 0  
To view an IC, click on IC Title