Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Banking Information - Individuals and Households New 9479 3128 0 Form and Instruction FEMA Form FF-104-FY-22-251
Form and Instruction FEMA Form FF-104-FY-22-251-A
Banking Information - Private Sector New 18959 6256 0 Form and Instruction FEMA Form FF-104-FY-22-251
Form and Instruction FEMA Form FF-104-FY-22-251-A
Banking Information - State, Local & Tribal Governement New 287 95 0 Form and Instruction FEMA Form FF-104-FY-22-251
Form and Instruction FEMA Form FF-104-FY-22-251-A
Notice of Loss - Individuals and Households Modified 9479 7109 0 Form and Instruction FEMA Form FF-104-FY-22-230
Form and Instruction FEMA Form FF-104-FY-22-230-A
Notice of Loss - Private Sector Modified 18959 14219 0 Form and Instruction FEMA Form FF-104-FY-22-230
Form and Instruction FEMA Form FF-104-FY-22-230-A
Notice of Loss - State, Local, and Tribal Governments Modified 287 215 0 Form and Instruction FEMA Form FF-104-FY-22-230
Form and Instruction FEMA Form FF-104-FY-22-230-A
Partial Payment Release and Certification Form (Entity) - Private Sector New 18959 4740 0 Form and Instruction FEMA Form FF-104-FY-22-253
Form and Instruction FEMA Form FF-104-FY-22-253-A
Partial Payment Release and Certification Form (Entity) - State, Local and Tribal Governments New 287 72 0 Form and Instruction FEMA Form FF-104-FY-22-253
Form and Instruction FEMA Form FF-104-FY-22-253-A
Partial Payment Release and Certification Form - Individuals and Households New 9479 2370 0 Form and Instruction FEMA Form FF-104-FY-22-252
Form and Instruction FEMA Form FF-104-FY-22-252-A
Proof of Loss - Individuals and Households Modified 9479 213278 0 Form and Instruction FEMA Form FF-104-FY-22-231
Form and Instruction FEMA Form FF-104-FY-22-231-A
Proof of Loss - Private Sector Modified 18959 426578 0 Form and Instruction FEMA Form FF-104-FY-22-231
Form and Instruction FEMA Form FF-104-FY-22-231-A
Proof of Loss - State, Local, and Tribal Governments Modified 287 6458 0 Form and Instruction FEMA Form FF-204-FY-22-231
Form and Instruction FEMA Form FF-204-FY-22-231-A
Request to Supplement Claim - Individuals and Households New 9479 1611 0 Form and Instruction FEMA Form FF-104-FY-22-254
Form and Instruction FEMA Form FF-104-FY-22-254-A
Request to Supplement Claim - Private Sector New 18959 3223 0 Form and Instruction FEMA Form FF-104-FY-22-254
Form and Instruction FEMA Form FF-104-FY-22-254-A
Request to Supplement Claim - State, Local and Tribal Governments New 287 49 0 Form and Instruction FEMA Form FF-104-FY-22-254
Form and Instruction FEMA Form FF-104-FY-22-254-A
Total burden requested under this ICR: 143625 689401 0  
To view an IC, click on IC Title