DEPARTMENT OF HOMELAND SECURITY O.M.B. No. 1660-0002
Federal Emergency Management Agency
RESOURCE REQUEST FORM (RRF) |
O.M.B. No. 1660-0002 |
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I. REQUESTING ASSISTANCE (Completed by Requestor) |
1. Requestor's Name
{var fldI1} |
2. Title
{var fldI2} |
3. Phone No.
{var fldI3}
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4. Requestor's Organization
{var fldI4} |
5. Fax No.
{var fldI5} |
6. E-Mail Address
{var fldI6} |
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II. REQUESTING ASSISTANCE (Completed by Requestor) |
1. Description of Requested Assistance:
{var fldII1} |
2. Quantity {var fldII2} |
3. Priority
{var fldII3} |
4. Date and Time Needed
{var fldII4} |
5. Delivery Site Location
{var fldII5} |
6. Site Point of Contact (POC)
{var fldII6} |
7. 24 Hour Phone No
{var fldII7} |
8. Fax No.
{var fldII8} |
9. State Approving Official Signature
{var fldII9} |
10. Date and Time
{var fldII10} |
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III. SOURCING THE REQUEST - REVIEW/COORDINATION (Operations) |
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IV. STATEMENT OF WORK (Operations Only) |
1. OFA Action Officer
{var fldIV1} |
2. 24 Hour Phone #
{var fldIV2}
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3. Fax #
{var fldIV3} |
4. FEMA Project Manager
{var fldIV4} |
5. 24 Hour Phone #
{var fldIV5} |
6. Fax #
{var fldIV6} |
7. Statement of Work
{var fldIV7} |
8. Estimated Completion Date {var fldIV8} |
9. Estimated Cost {var fldIV9} |
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V. ACTION TAKEN (Operations Only) |
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Reason / Disposition
{var fldVReason}
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TRACKING INFORMATION (FEMA) |
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FEMA FORM 010-0-7
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Ver 1.9 KE4WLT
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