Document ID: FEMA-2009-0001-0103
Agency: fema
Document Type: Notice
Title: Agency Information Collection Activities; Proposals, Submissions, and Approvals: General Admissions Application (Long and Short) and Stipend Forms
Posted Date: 2010-05-05T04:00Z

[Federal Register: May 5, 2010 (Volume 75, Number 86)]
[Notices]               
[Page 24722-24723]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr05my10-110]                         

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DEPARTMENT OF HOMELAND SECURITY

Federal Emergency Management Agency

[Docket ID: FEMA-2009-0001]

 
Agency Information Collection Activities: Submission for OMB 
Review; Comment Request, OMB No. 1660-0100; General Admissions 
Application (Long and Short) and Stipend Forms

AGENCY: Federal Emergency Management Agency, DHS.

ACTION: Notice; 30-day notice and request for comments; revision of a 
currently approved information collection; OMB No. 1660-0100; FEMA 
Forms 119-25-1 (replaces FEMA Form 75-5), General Admissions 
Application; 119-25-2 (replaces FEMA Form 75-5a), General Admissions 
Application Short-Form; 119-25-3 (replaces FEMA Form 75-3), Student 
Stipend Agreement; and 119-25-4 (replaces FEMA For 75-3a), Student 
Stipend Agreement (Amendment); FEMA Form 119-25-5 (replaces FEMA Form 
95-22) National Fire Academy Executive Fire Officer Program Application 
Admission.

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SUMMARY: The Federal Emergency Management Agency (FEMA) has submitted 
the information collection abstracted below to the Office of Management 
and Budget for review and clearance in accordance with the requirements 
of the Paperwork Reduction Act of 1995. The submission describes the 
nature of the information collection, the categories of respondents, 
the estimated burden (i.e., the time, effort and resources used by 
respondents to respond) and cost, and the actual data collection 
instruments FEMA will use.

DATES: Comments must be submitted on or before June 4, 2010.

ADDRESSES: Submit written comments on the proposed information 
collection to the Office of Information and Regulatory Affairs, Office 
of Management and Budget. Comments should be addressed to the Desk 
Officer

[[Page 24723]]

for the Department of Homeland Security, Federal Emergency Management 
Agency, and sent via electronic mail to oira.submission@omb.eop.gov or 
faxed to (202) 395-5806.

FOR FURTHER INFORMATION CONTACT: Requests for additional information or 
copies of the information collection should be made to Director, 
Records Management Division, 1800 South Bell Street, Arlington, VA 
20598-3005, facsimile number (202) 646-3347, or e-mail address FEMA-
Information-Collections-Management@dhs.gov.

SUPPLEMENTARY INFORMATION:

Collection of Information

    Title: General Admissions Application (Long and Short) and Stipend 
Forms.
    Type of information collection: Revision of a currently approved 
information collection.
    OMB Number: 1660-0100.
    Form Titles and Numbers: FEMA Forms 119-25-1 (replaces FEMA Form 
75-5), General Admissions Application; 119-25-2 (replaces FEMA Form 75-
5a), General Admissions Application Short-Form; 119-25-3 (replaces FEMA 
Form 75-3), Student Stipend Agreement; and 119-25-4 (replaces FEMA For 
75-3a), Student Stipend Agreement (Amendment); FEMA Form 119-25-5 
(replaces FEMA Form 95-22) National Fire Academy Executive Fire Officer 
Program Application Admission. The form numbers have changed since 
publication of the 60-day Federal Register Notice at 75 FR 8386, 
February 24, 2010.
    Abstract: FEMA personnel use the application forms to admit 
applicants to courses and programs offered at National Emergency 
Training Center (NETC), the Noble Training Facility (NTF), and various 
locations throughout the United States. The FEMA Form 119-25-1, General 
Admissions Application is the regular form and FEMA Form 119-25-2 is 
the short form used when FEMA personnel are not required to determine 
eligibility for courses and programs. FEMA Form 119-25-5 and the 
requested supporting documentation Letter of Intent, Resume, Letter of 
Recommendation, Diploma Photocopy, and Organizational Chart is used to 
select applicants to the Executive Fire Officer Program. FEMA Forms 
119-25-3 and 119-25-4, Student Stipend Agreement and Student Stipend 
Agreement (Amendment), respectively, are provided to individuals who 
have been accepted to attend certain courses for which a stipend is 
paid. The 119-25-4 form is used when there is a supplemental 
reimbursement request for expenses that occur after arrival at the 
training site.
    Affected Public: Individuals or households; Businesses or other 
for-profit; State, Local or Tribal Government; Not-for-profit 
institutions; Federal Government.
    Estimated Number of Respondents: 109,800.
    Frequency of Response: On Occasion.
    Estimated Average Hour Burden per Respondent: .11 Hours.
    Estimated Total Annual Burden Hours: 12,350 Hours.
    Estimated Cost: There is no annual operation, maintenance, capital 
or start-up cost associated with this collection.

    Dated: April 28, 2010.
Samuel C. Smith,
Acting Director, Records Management Division, Mission Support Bureau, 
Federal Emergency Management Agency, Department of Homeland Security.
[FR Doc. 2010-10529 Filed 5-4-10; 8:45 am]
BILLING CODE 9111-45-P