Information Collection Request

Public Assistance Program

ICR 202109-1660-002 · OMB 1660-0017 · Received in OIRA

⚠️ Notice: This information collection may be outdated.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

Forms and Documents

Document	Type	Status	Availability
Form FEMA Form 009-0-49 Request for Public Assistance	Form	Unchanged	Repair queued
Form FEMA Template 104- FEMA Template 104-FY-21-100 Equitable COVID-19 Response and Recovery: Vaccine Administration Information	Form and Instruction	Unchanged	Available
Form 009-0-141 FAC-TRAX System	Form	Unchanged	Repair queued
Form FEMA Form 009-0-91 Project Worksheet Photo Sheet	Form	Unchanged	Repair queued
Form FEMA Form 009-0-91 Project Worksheet Maps and Sketches Sheet	Form	Unchanged	Repair queued
Form FEMA Form 009-0-91 Project Worksheet Cost Estimate Continuation Sheet and Cost Overruns	Form	Unchanged	Repair queued
Form FEMA Form 009-0-91 Project Work Sheet Damage Description and Scope of Work	Form	Unchanged	Repair queued
Form FEMA Form 009-0-12 Force Account Equipment Summary Record	Form	Unchanged	Repair queued
Form FEMA Form 009-0-12 Contract Work Summary Record	Form	Unchanged	Repair queued
Form FEMA Form 009-0-12 Rented Equipment Summary Record	Form	Unchanged	Repair queued
Form FEMA Form 009-0-12 Materials Summary Record	Form	Unchanged	Repair queued
Form FEMA Form 009-0-12 Force Account Labor Summary	Form	Unchanged	Repair queued
Form FEMA Form 009-0-12 PNP Facility Questionnaire	Form	Unchanged	Repair queued
Form FEMA Form 009-0-12 Applicant's Benefits Calculation Worksheet	Form	Unchanged	Missing upstream
Form FEMA Form 009-0-12 Special Considerations Questions	Form	Unchanged	Repair queued
Form FEMA Form 009-0-91 Project Worksheet	Form and Instruction	Unchanged	Repair queued
Form FEMA Form 009-0-11 Progress Report	Form and Instruction	Unchanged	Repair queued
1660-0017 Final Rule Supporting Statement A 2021 09 09.docx	Supporting Statement A	Uploaded 2021-09-09	Repair queued
Equitable COVID-19 Response and Recovery Job Aid 3-15-21.pdf	Supplementary Document	Uploaded 2021-03-30	Repair queued
stafford_act.pdf	Supplementary Document	Uploaded 2016-09-02	Repair queued
CFR-2011-title44-vol1-part206.pdf	Supplementary Document	Uploaded 2016-09-01	Repair queued

IC Document Collections

IC ID	Collection	Type	Status
41294	Request for Public Assistance	Form	Unchanged
247457	FEMA Template 104-FY-21-100 Equitable COVID-19 Response and Recovery: Vaccine Administration Information	Form and Instruction	Unchanged
223320	FAC-TRAX System	Form	Unchanged
206469	Project Worksheet Photo Sheet	Form	Unchanged
206468	Project Worksheet Maps and Sketches Sheet	Form	Unchanged
206467	Project Worksheet Cost Estimate Continuation Sheet and Cost Overruns	Form	Unchanged
206466	Project Work Sheet Damage Description and Scope of Work	Form	Unchanged
191941	State Administrative Plan and Amendments		Unchanged
190424	Request for Arbitration and Recommendation from Hurricanes Katrina or Rita		Unchanged
190419	Request for Appeals and Recommendation		Unchanged
185911	Force Account Equipment Summary Record	Form	Unchanged
185910	Contract Work Summary Record	Form	Unchanged
185909	Rented Equipment Summary Record	Form	Unchanged
185908	Materials Summary Record	Form	Unchanged
185907	Force Account Labor Summary	Form	Unchanged
185906	PNP Facility Questionnaire	Form	Unchanged
185903	Applicant's Benefits Calculation Worksheet	Form	Unchanged
185901	Special Considerations Questions	Form	Unchanged
185900	Project Worksheet	Form and Instruction	Unchanged
185897	Progress Report	Form and Instruction	Unchanged

ICR Details

Status	Received in OIRA
Agency/Subagency	DHS/FEMA
OMB Control No	1660-0017
Type of Information Collection	Revision of a currently approved collection
Previous ICR Reference No	202105-1660-001
Agency Tracking No	Final Rule
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31