Information Collection

FEMA-Administered DCM Consent Form

IC 250278 under ICR 202602-1660-001 · OMB 1660-0152.

Documents and Forms

Document Name Document Type
Form FEMA Form FF-104-F FEMA-Administered DCM Concent Form FEMA-Administered DCM Consent Form Form
FEMA Form FF-104-F FEMA-Administered DCM Concent Form FEMA Form FF-104-FY-21-147-DRAFT.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FEMA-Administered DCM Consent Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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-21-147	FEMA-Administered DCM Concent Form	FEMA Form FF-104-FY-21-147-DRAFT.pdf		No		Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12,300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	12,300	-17,700	30,000
Annual IC Time Burden (Hours)	1,230	-1,770	3,000
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.

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