Direct Housing Assistance Forms

Forms and Documents

Document Name	Status
Form FF-104-FY-21-113 ( Transportable Temporary Housing Unit Maintenance Work Order Form and Instruction	Unchanged
Form FF-104-FY-21-112 ( Transportable Temporary Housing Unit Installation Work Order Form and Instruction	Unchanged
Form FF-104-FY-21-111 ( Transportable Temporary Housing Unit Inspection Report Form and Instruction	Unchanged
Form FF-104-FY-21-110 ( Transportable Temporary Housing Unit Landowner's Authorization Ingress-Egress Agreement Form and Instruction	Unchanged
Form FF-104-FY-21-109 ( Transportable Temporary Housing Unit Request for the Site Inspection Form and Instruction	Unchanged
Form FF-104-FY-21-194 ( Direct Temporary Housing Assistance Temporary Housing Agreement Form and Instruction	Modified
Form FF-104-FY-21-193 ( Direct Temporary Housing Assistance Recertification Worksheet Form and Instruction	Unchanged
Form FF-104-FY-21-191 ( Transportable Temporary Housing Unit Ready for Occupancy Status Form and Instruction	Unchanged
Form FF-104-FY-21-192 ( Sales Calculation Worksheet Form and Instruction	Unchanged
Form FF-104-FY-21-195 ( Commercial Park Unit Pad Requirements – Information Checklist Form and Instruction	Unchanged
1600-0138 - Signed Change Request for Spanish Translation - 2023 12 18.pdf Justification for No Material/Nonsubstantive Change	2023-12-19
NOC - FF-104-FY-21-113_TTHU Maintenance Work Order_REVISED.docx Supplementary Document	2021-12-23
NOC - FF-104-FY-21-112_TTHU Installation Work Order_REVISED.docx Supplementary Document	2021-12-23
NOC - FF-104-FY-21-111_TTHU Inspection Report_REVISED.docx Supplementary Document	2021-12-23
NOC - FF-104-FY-110-A_Autorizacion del Propietario_REVISED.docx Supplementary Document	2021-12-23
NOC - FF-104-FY-21-110_Landowners Authorization_REVISED.docx Supplementary Document	2021-12-23
NOC - FF-104-FY-21-109_Request for the Site Inspection_REVISED.docx Supplementary Document	2021-12-23
NOC - 009-0-137_Unit Pad Requirements_REVISED.docx Supplementary Document	2021-12-23
NOC - 009-0-135_Temporary Housing Agreement_REVISED.docx Supplementary Document	2021-12-23
NOC - 009-0-134_Recertification Worksheet_REVISED.docx Supplementary Document	2021-12-23
NOC - 009-0-129_Ready for Occupancy Status_REVISED.docx Supplementary Document	2021-12-23
1660-0138 Published 30-Day Revision FRN - 2021 12 30.pdf Supplementary Document	2021-12-30
1660-0138 Published 60-Day Revision FRN - 2021 10 13.pdf Supplementary Document	2021-12-06
CFR-2003-title44-vol1-sec206-117.pdf Supplementary Document	2021-12-06
Disaster Mitigation Act of 2000 (PL 106-390).pdf Supplementary Document	2021-12-06
Stafford Diaster Relief and Emergency Assistance Act (PL 100-707).pdf Supplementary Document	2021-12-06
1660-0138 - Supporting Statement A - 20223 12 19 clean.docx Supporting Statement A	2023-12-19

IC Document Collections

IC ID	Document Title	Status
250693	Transportable Temporary Housing Unit Maintenance Work Order Form and Instruction	Unchanged
250692	Transportable Temporary Housing Unit Installation Work Order Form and Instruction	Unchanged
250691	Transportable Temporary Housing Unit Inspection Report Form and Instruction	Unchanged
250689	Transportable Temporary Housing Unit Landowner's Authorization Ingress-Egress Agreement Form and Instruction	Unchanged
250688	Transportable Temporary Housing Unit Request for the Site Inspection Form and Instruction	Unchanged
216403	Direct Temporary Housing Assistance Temporary Housing Agreement Form and Instruction	Modified
216401	Direct Temporary Housing Assistance Recertification Worksheet Form and Instruction	Unchanged
216400	Transportable Temporary Housing Unit Ready for Occupancy Status Form and Instruction	Unchanged
216399	Sales Calculation Worksheet Form and Instruction	Unchanged
216398	Commercial Park Unit Pad Requirements – Information Checklist Form and Instruction	Unchanged

ICR Details

OMB Control No: 1660-0138	ICR Reference No: 202312-1660-002
Status: Received in OIRA	Previous ICR Reference No: 202112-1660-002
Agency/Subagency: DHS/FEMA	Agency Tracking No: Spanish Change Request
Title: Direct Housing Assistance Forms
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/19/2023

	Requested	Previously Approved
Expiration Date	07/31/2025	07/31/2025
Responses	25,900	25,900
Time Burden (Hours)	5,824	5,824
Cost Burden (Dollars)	0	0

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Abstract: This new instrument is simply a translation of the current Direct Temporary Housing Assistance Temporary Housing Agreement, FEMA Form FF-104-FY-21-194 (formerly 009-0-135) into the Spanish language.

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Authorizing Statute(s): US Code: 42 USC 5174 Name of Law: Robert T. Stafford Disaster Relief and Emergency Assistance Act
   PL: Pub.L. 106 - 390 206 Name of Law: The Disaster Mitigation Act of 2000
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 56979	10/13/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 74418	12/30/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 10

IC Title	Form No.	Form Name
Commercial Park Unit Pad Requirements – Information Checklist	FF-104-FY-21-195 (formerly 009-0-137)	Commercial Park Unit Pad Requirements – Information Checklist
Direct Temporary Housing Assistance Recertification Worksheet	FF-104-FY-21-193 (formerly 009-0-134)	Direct Temporary Housing Assistance Recertification Worksheet
Direct Temporary Housing Assistance Temporary Housing Agreement	FF-104-FY-21-194 (formerly 009-0-135), FEMA Form FF-104-FY-21-194-A	Direct Temporary Housing Assistance Temporary Housing Agreement ,   Asistencia Directa Para Vivienda Temporal Acuerdo de Vivienda Temporal
Sales Calculation Worksheet	FF-104-FY-21-192 (formerly 009-0-131)	Sales Calculation Worksheet
Transportable Temporary Housing Unit Inspection Report	FF-104-FY-21-111 (formerly 009-0-138)	Transportable Temporary Housing Unit Inspection Report
Transportable Temporary Housing Unit Installation Work Order	FF-104-FY-21-112 (formerly 009-0-136)	Transportable Temporary Housing Unit Installation Work Order
Transportable Temporary Housing Unit Landowner's Authorization Ingress-Egress Agreement	FF-104-FY-21-110 (formerly 010-0-10), FF-104-FY-21-110-A (formerly 010-0-10S)	Transportable Temporary Housing Unit Landowner’s Authorization Ingress-Egress Agreement ,   Autorización del Propietario/Acuerdo de Entrada y Salida
Transportable Temporary Housing Unit Maintenance Work Order	FF-104-FY-21-113 (formerly 009-0-130)	Transportable Temporary Housing Unit Maintenance Work Order
Transportable Temporary Housing Unit Ready for Occupancy Status	FF-104-FY-21-191 (formerly 009-0-129)	Transportable Temporary Housing Unit Ready for Occupancy Status
Transportable Temporary Housing Unit Request for the Site Inspection	FF-104-FY-21-109 (formerly 010-0-9)	Transportable Temporary Housing Unit Request for the Site Inspection

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	25,900	25,900	0	0	0	0
Annual Time Burden (Hours)	5,824	5,824	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $10,631,850

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/19/2023

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