Student Stipend Agreement (Amendment)

General Admissions Application (Long and Short) and Stipend Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0100 can be found here:

Documents and Forms

Document Name Document Type
Form FEMA Form 119-25-4 Student Stipend Agreement (Amendment) Form and Instruction
FEMA Form 119-25-4 Studen Stipend Agreement (Amendment) FEMA Form 119-25-4.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Student Stipend Agreement (Amendment)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

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 119-25-4	Studen Stipend Agreement (Amendment)	FEMA Form 119-25-4.pdf		No		Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title: Training and Exercise Program Records System	FR Citation: 76 FR 19107

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	500	-500	1,000
Annual IC Time Burden (Hours)	17	-16	33
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.