Information Collection

Request for Public Assistance

IC 41294 under ICR 202212-1660-015 · OMB 1660-0017.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form FEMA Form FF-104-F Request for Public Assistance Form and Instruction
FEMA Form FF-104-F Request for Public Assistance FF-104-FY-21-131_Request for Public Assistance_Final.docx portal.fema.gov/famsVuWeb/home Form and Instruction
FEMA Form FF-104-F Request for Public Assistance FF-104-FY-21-131_Request for Public Assistance_Final.docx portal.fema.gov/famsVuWeb/home Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Public Assistance	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 44 CFR 206

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FEMA Form FF-104-FY-21-131 (formerly 009-0-49)	Request for Public Assistance	FF-104-FY-21-131_Request for Public Assistance_Final.docx	https://portal.fema.gov/famsVuWeb/home	Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	60,000	52,776	7,224
Annual IC Time Burden (Hours)	7,002	5,196	1,806
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.