Information Collection

Promissory Note

IC 188996 under ICR 202301-1660-003 · OMB 1660-0083.

Documents and Forms

Document Name Document Type
Form FEMA Form FF-104-F Promissory Note Form
FEMA Form FF-104-F PROMISSARY NOTE FEMA Form FF-104-FY-22-224 (formerly 116-0-1).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Promissory Note	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	FEMA Form FF-104-FY-22-224 (formerly 116-0-1)	PROMISSARY NOTE	FEMA Form FF-104-FY-22-224 (formerly 116-0-1).pdf		Yes	No	Fillable Printable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title: DHS/FEMA-009 - Hazard Mitigation Disaster Public Assistance and Disaster Loan Programs	FR Citation: 79 FR 16015

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	50	0	50
Annual IC Time Burden (Hours)	100	-100	200
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.