How to Fill Out FEMA Form FF-104-FY-21-137

FEMA Form FF-104-FY-21-137 at a glance

What it is: Force Account Labor Summary from the Federal Emergency Management Agency (OMB Control Number 1660-0017).

A filled-in FEMA Form FF-104-FY-21-137 example: a clerk summarizes one worker's week

FEMA Form FF-104-FY-21-137 example filled out, example: a clerk summarizes one worker's week
Pat Sample, a county clerk, fills out the form for one worker. Lee Roe worked 5 regular hours and 1 overtime hour on each day of the week. The picture shows page 1, and every value in it is made up. The week runs from March 2 to March 8, 2026. Regular time pays 20.00 an hour, overtime pays 30.00 an hour, and the benefit rate is 5.00 an hour. Each total hourly rate adds the hourly rate and the benefit rate, and each total cost multiplies it by the total hours. The example lists one worker, so the other worker rows stay empty.

How to fill out FEMA Form FF-104-FY-21-137, box by box

Disaster, project and applicant

FEMA Form FF-104-FY-21-137 example filled out, disaster, project and applicant

Enter the DISASTER, PROJECT #, PA ID # and APPLICANT.

Period covering, category and location or site

FEMA Form FF-104-FY-21-137 example filled out, period covering, category and location or site

Enter the PERIOD COVERING, CATEGORY and LOCATION/SITE.

Description of work performed

FEMA Form FF-104-FY-21-137 example filled out, description of work performed

Enter the DESCRIPTION OF WORK PERFORMED.

Name, job title and dates and hours worked each week

FEMA Form FF-104-FY-21-137 example filled out, name, job title and dates and hours worked each week

Enter the NAME and JOB TITLE.

Enter the DATES AND HOURS WORKED EACH WEEK.

Costs

FEMA Form FF-104-FY-21-137 example filled out, costs

Under Costs, fill in Total Hours, Hourly Rate, Benefit Rate/Hr, Total Hourly Rate and Total Costs.

Total costs for force account labor

FEMA Form FF-104-FY-21-137 example filled out, total costs for force account labor

Enter the Total Costs for Force Account Labor Regular Time.

Enter the Total Cost for Force Account Labor Overtime.

Certification

FEMA Form FF-104-FY-21-137 example filled out, certification

The information was obtained from payroll records, invoices, or other documents that are available for audit.

Fill in CERTIFIED, TITLE and DATE.

Sources

[1] FEMA Form FF-104-FY-21-137 (05/21), Force Account Labor Summary, Federal Emergency Management Agency (the Official source link on this page).

FEMA Form FF-104-FY-21-137 PDF Details

Period covering, category, location/site, disaster, project #, PA ID # and applicant.

Hours worked: Name, job title and dates and hours worked each week.

Costs: Total hours, hourly rate, benefit rate/hr, total hourly rate and total costs.

Totals: Total costs for force account labor, regular time and overtime.

Certification: The information above was obtained from payroll records, invoices, or other documents that are available for audit.

Reporting burden: Estimated to average .5 hours per response.

OMB control number: 1660-0017.

QuestionAnswer
Form NameFEMA Form FF-104-FY-21-137
Form Length1 page
Fillable?Yes
Fillable fields126
Avg. time to fill out21 min
Edition05/21
Issuing agencyFederal Emergency Management Agency
OMB control number1660-0017
Other namesFEMA Form 90-123, FEMA 90-123, 90-123, 009-0-123, FF-104-FY-21-137, Force Account Labor Summary

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