OMB control number

Generic Clearance for Notice of Loss and Proof of Loss

OMB 1660-0159 · DHS/FEMA.

OMB 1660-0159

The Federal Emergency Management Agency (FEMA) will use the collected information to commence the process and procedures for claimants to seek compensation for injury or loss of property resulting from the Hermit’s Peak/Calf Canyon Fire and other fires that meet the criteria. Affected state, local and Tribal governments, private sector businesses, not-for-profit organizations, and individuals and households that suffered injuries resulting from fires will be eligible to apply for compensation. Claimants will submit a Notice of Loss to the Agency, meet with a FEMA Claims Reviewer, obtain documentation needed to substantiate claims, sign a Proof of Loss, and complete and return a Release and Certification form.

The latest form for Generic Clearance for Notice of Loss and Proof of Loss expires 2026-11-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form FEMA Form FF-104-F Third Batch of Hermits Peak Instruments (New) Form
Form FEMA Form FF-104-F Second Batch of Hermits Peak Instruments (Revised) Form
Form FEMA Form FF-104-F Generic Clearance for Notice of Loss and Proof of Loss Form
1660-0159 - Supporting Statement A - 2024 03 29.docx Supporting Statement A
1660-0159 Signed Change Request - 2024 03 27.pdf Justification for No Material/Nonsubstantive Change
1660-NW163 - Published 30-Day New Generic FRN - 2023 08 11.pdf Supplementary Document
1660-NW163 - Published 60-Day New Generic FRN - 2023 05 05.pdf Supplementary Document
PLAW-117publ103.pdf Supplementary Document
USCODE-2021-title42-chap68.pdf Supplementary Document
Third Batch of Hermits Peak Instruments (New) Form
Second Batch of Hermits Peak Instruments (Revised) Form
Generic Clearance for Notice of Loss and Proof of Loss Form

All Historical Document Collections

202404-1660-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2024-04-05
202403-1660-006 Approved without change	No material or nonsubstantive change to a currently approved collection	2024-04-04
202305-1660-002 Approved without change	New collection (Request for a new OMB Control Number)	2023-08-28

OMB Details

Generic Clearance for Notice of Loss and Proof of Loss

Federal Enterprise Architecture: Disaster Management - Disaster Repair and Restore

Form FEMA Form FF-104-FY-22-252-A	#2 Release and Certification (Individual/Household)- Partial Payment (Spanish)	Printable Only	Form
Form FEMA Form FF-104-FY-22-251-A	Banking Information Form (Spanish)	Printable Only	Form
Form FEMA Form FF-104-FY-22-251	Banking Information Form (English)	Printable Only	Form
Form FEMA Form FF-104-FY-22-254-A	#5 Request to Supplement Claim (Spanish)	Printable Only	Form
Form FEMA Form FF-104-FY-22-252	#2 Release and Certification (Individual/Household)- Partial Payment (English)	Printable Only	Form
Form FEMA Form FF-104-FY-22-254	#5 Request to Supplement Claim (English)	Printable Only	Form
Form FEMA Form FF-104-FY-22-230-A	#4 Notice of Loss (Spanish)	Printable Only	Form
Form FEMA Form FF-104-FY-22-230	#4 Notice of Loss (English)	Printable Only	Form
Form FEMA Form FF-104-FY-22-253-A	#3 Release and Certification (Entity)- Partial Payment (Spanish)	Printable Only	Form
Form FEMA Form FF-104-FY-22-253	#3 Release and Certification (Entity)- Partial Payment (English)	Printable Only	Form
Form FEMA Form FF-104-FY-22-231	#1 Proof of Loss (English)	Printable Only	Form
Form FEMA Forn FF-104-FY-22-231-A	#1 Proof of Loss (Spanish)	Printable Only	Form

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.