Forms

Public Assistance Program

Application Forms:

Cal EMA 89 - Grant Assurances (.pdf) - This is a required document for all federal disaster assistance grants.

Cal EMA 95 List of Projects (.xls) - This Excel form used to submit an applicant's List of Projects for federal disaster assistance.

Cal EMA 126 - CDAA Application (.pdf) - Project Application and Assurances for California Disaster Assistance Act (CDAA) Program.  This is a required document for all state only disaster assistance.

Cal EMA 130 - Designation of Applicant's Agent Resolution (.pdf) - This is a required document for all applicants except state agencies, for all state and federal disaster assistance.

Cal EMA 130 SA - Signature Authority Form (.pdf) - This is a required document for all state agencies requesting state and federal disaster assistance.
 
Cal EMA 131 - Large Project Reimbursement Request Form (.pdf) - Used for all disasters prior to 1498.
 
Cal EMA 132 - Large Project Reimbursement Request Form (.pdf) - Used for all disasters from DR-1498 and onward.

California Disaster Assistance Act (CDAA) 4a - This is a required document for all applicants receiving state disaster assistance.

Std. 204 - Payee Data Record - Form required for all non-governmental entities.

FEMA Request for Public Assistance (FEMA Form 90-049) (.pdf) - Request for Public Assistance for federal disaster assistance.

Request for Fire Assistance Grant (FEMA Form 90-133) (.pdf) - Application for the federal Fire Management Assistance Grant program.
Cost Accounting Forms:
Contract Work Summary Record (FEMA Form 90-126) (.xls) – This form is used to summarize work completed by contract.

Force Account Equipment Summary Record (FEMA Form 90-127) (.xls) – This form is used to summarize applicant owned equipment expenses.

Force Account Labor Summary (FEMA Form 90-123) (.xls)
- This form is used to summarize applicant employee labor expenses.

Materials Summary Record (FEMA Form 90-124) (.xls)This form is used to summarize expenses for materials (purchased or from stock).
 
Rented Equipment Summary Record (FEMA Form 90-125) (.xls) - This form is used to summarize rented equipment expenses.
 
Information Sheets:
DUNS Number Information Sheet (.pdf)- Information on how to obtain a Dun and Bradstreet Number (DUNS); required from all applicants receiving federal grant funding.
 
Federal Assistance Requirement Information (.pdf) - Information sheet listing all documents required to receive federal PA funding.

Private Nonprofit (PNP) Program

Application Forms

Cal EMA PNP-2011-APP - Application (.pdf) - This is a required document for the State Private Nonprofit Organizations Assistance Program. 

Cal EMA PNP-2011-AAR - Authorized Agent Resolution (.pdf) - This is a required document for the State Private Nonprofit Organizations Assistance Program. 

Cal EMA PNP-2011-ACF - Activities Claim Form (.pdf) - This is a required document for the State Private Nonprofit Organizations Assistance Program.  

Std. 204 - Payee Data Record - Form required for all non-governmental entities.