View Information Collection Request (ICR) Package

OMB Control No: 1660-0100	ICR Reference No: 201307-1660-009
Status: Historical Active	Previous ICR Reference No: 201209-1660-003
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: General Admissions Application (Long and Short) and Stipend Forms
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/15/2013
	Date Received in OIRA: 08/01/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2016	36 Months From Approved	11/30/2013
Responses	112,800	0	109,400
Time Burden (Hours)	12,900	0	11,783
Cost Burden (Dollars)	0	0	0

Abstract: FEMA is responsible for providing training to meet the needs of disaster preparedness requirements set forth by regulation. To facilitate meeting these requirements, FEMA collects applicant information necessary to register for courses and to receive stipends for the courses. FEMA uses the application forms to admit applicants to courses and programs offered at National Emergency Training Center (NETC), the Noble Training Facility (NTF), and various locations throughout the United States.

Authorizing Statute(s): EO: EO 12127 Name/Subject of EO: Federal Emergency Management Agency
   US Code: 42 USC 5121-5207 Name of Law: Robert T. Stafford Disaster Relief and Emergency Assistance Act
   EO: EO 12148 Name/Subject of EO: Federal Emergency Management

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 20330	04/04/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 38067	06/25/2013
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
Executive Fire Officer program Application for Admission	FEMA Form 119-25-5
General Admissions Application	FEMA Form 119-25-1
General Admissions Application - Short Form	FEMA Form 119-25-2
Student Stipend Agreement	FEMA Form 119-25-3
Student Stipend Agreement	119-25-3
Student Stipend Agreement (Amendment)	FEMA Form 119-25-4

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	112,800	109,400	0	3,400
Annual Time Burden (Hours)	12,900	11,783	500	617
Annual Cost Burden (Dollars)	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: FEMA Form 119-25-1 has an increase in the number of respondents from 15,000 to 25,000 (+10,000) because FEMA Form 119-25-1 (automated) was not put into use due to problems with the computerized system that was being used to collect the input and the system not being put into operation. The individuals who were expected to use the FEMA Form 119-25-1 (automated) are using the FEMA Form 119-25-1. There was also an adjustment increase from 2,250 hours to 3,750 (+1,500) hours. Part of this is related to the 1,333 hours that were estimated for the FEMA Form 119-25-1 (automated) that was not being utilized. The additional 167 hours is due to the increase time (8 minutes to 9) to complete the FEMA Form 119-25-1 as compared to the FEMA Form 119-25.1 (automated). FEMA Form 119-25-1 (automated) is no longer being used and the FEMA Forms 119-25-1 is being used for this purpose. This has resulted in a reduction of 10,000 respondents and a decrease of 1,333 burden hours for the FEMA Form 119-25-1 (automated). FEMA Form 119-25-2 has a burden increase from 75,000 respondents to 80,000 respondents (+5,000) and a corresponding increase in burden hours from 7,500 to 8,000 (+500) due to the increased usage of this form. The number of respondents using this form has been steadily increasing since the last information collection budget submission. This is due to a an increase in the number of off-campus course deliveries. FEMA Form 119-25-3 has a burden decrease of 1,000 respondents to 7,000 respondents . This decrease is due to a reduction in the number respondents submitting requests for student stipend reimbursements. The burden hours for this collection has a decrease from 267 to 233 (-34) hours due to a reduction in the use of this form. FEMA Form 119-25-3 was mistakenly entered into the ROCIS system twice with an estimation of 8000 respondents and 267 burden hours. The burden estimates were removed from this collection. FEMA Form 119-25-4 has a decrease in respondents from 1000 to 500. The decrease is due to a reduction in the number of respondents submitting amendments to the student stipend reimbursement form (FEMA Form 119-25-3). The burden hours for this collection have an adjustment decrease from 33 to 17 (-16) hours due to a reduction in the number of respondents submitting stipend amendments. FEMA Form 119-25-5 have a decrease from 400 to 300 (-100) respondents due to a reduction in the number of annual respondents applying for the Executive Fire Officer Program. The burden hours for this collection have an adjustment of 900 hours from 400 (+500) hours due to the amount of additional time required to assemble and complete the FEMA Form 119-25-5 and the required supplemental documentation (responses to the questions on the form, letter of intent, resume, letters of recommendation, copies of diplomas, organizational chart, and a short essay).

Annual Cost to Federal Government: $184,106

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Lawann Johnson 202 646-4246 lawann.johnson@dhs.gov

View ICR - OIRA Conclusion