TxDPS - TDEM Forms and Publications

General Forms
Mitigation (Hazard Mitigation)

Mitigation - Plans (Hazard Mitigation)
Mitigation - Grant Programs
Mitigation - Public Outreach
Mitigation - Forms and Worksheets

State Emergency Response Commission (SERC)
- Local Emergency Planning Committee (LEPC)
Disaster Recovery
Selected Federal Forms

General Forms
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Form/Publication Title	Form Number
Emergency Management Director/Coordinator Appointment Updated December 2013. Use this version only.	TDEM-147.pdf
NIMS Fire Department Resolution	.pdf
NIMS Volunteer Fire Dept. Resolution	.pdf

Mitigation - Plans
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Form/Publication Title	Form Number
State of Texas Standard Mitigation Plan Update	.pdf
Local Mitigation Planning Package Fillable Local Mitigation Plan Review Tool Local Mitigation Plan Review Guide Local Mitigation Planning Handbook	.doc .pdf .pdf
See State Mitigation Action Plan: Annex A (under Grant Programs)

Mitigation - Grant Programs
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Form/Publication Title	Form Number
Hazard Mitigation Grant Program (HMGP) Fact Sheet	.pdf
Procurement Update	.pdf

Mitigation - Public Outreach
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Form/Publication Title	Form Number
Buyouts and Elevation Fact Sheet	.pdf

Mitigation - Application Packets
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Form/Publication Title	Form Number
Mitigation Action Plan Application Worksheet	TDEM-602.pdf
Generator Grant Application Worksheet TDEM-604	TDEM-604.pdf
Comprehensive Hazard Mitigation Application Guide	TDEM-618.pdf
Individual Safe Room Rebate Application Worksheet	TDEM-621.pdf

Mitigation - Forms and Worksheets
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Form/Publication Title	Form Number
Planning Grant Project Checklist	TDEM-601.pdf
Generator Grant Project Checklist	TDEM-603.pdf
Generator SOW	TDEM-605.pdf
Excluded Parties List Verification Form	TDEM-606.pdf
Federal Assurances	TDEM-607.pdf
State Application - HMGP Grants	TDEM-609.pdf
State of Texas Assurances	TDEM-610.pdf
SF-424 Federal Application with Instructions	TDEM-611.pdf
Floodplain Manager Form	TDEM-612.pdf
Project Officer Designation for Mitigation Grants	TDEM-613.pdf
Record of Environmental Consideration Pkg	TDEM-614.pdf
Third Party Authorization	TDEM-615.pdf
Benefit Cost Analysis Coversheet	TDEM-616.pdf
Benefit Cost Analysis	.htm
Comprehensive Application Checklist	TDEM-617.pdf
Mitigation Job Aid #7 Instructions for Coordinating Environmental and Historic Preservation Compliance for HMGP Project Applications	.pdf
FEMA Region VI Mitigation Grant Program Engineering Checklist	TDEM-619.pdf
Quarterly Progress Report Form	TDEM-620.pdf
Quarterly Payment Request Form	.xls
Demolition Certificate	.rtf
Certificate of Completion	.rtf

State Emergency Response Commission (SERC)
Local Emergency Planning Committees (LEPC)
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Form/Publication Title	Form Number
LEPC Membership Update Form	TDEM-151.pdf

Disaster Recovery
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Form/Publication Title	Form Number
Disaster Summary Outline
FEMA 90-91 - Project Worksheet w/ Cost Summary Attachments (full functioning Excel version - requires macros)	.xls
Request for Public Assistance	.pdf
Designation of Applicant's Agent	.pdf
Designation of Applicant's Agent	.rtf
Direct Deposit Authorization Form	.pdf
PNP Facility Questionnaire	.pdf
PNP Facility Questionnaire	.rtf
Record Keeping Instructions	.pdf
Texas Mileage Guide (for Travel Reimbursement)	.jsp
TDEM Texas Standard Incident Reimbursement Forms	.xls

Selected Federal Forms
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Form/Publication Title	Form Number
Assurances and Certifications Form 20-16 Summary Sheet Form 20-16A Assurances-Nonconstruction Programs Form 20-16B Assurances-Construction Programs Form 20-16C Certifications Regarding Lobbying Standard Form LLL Disclosure of Lobbying Activities	.pdf
Assurances and Certifications Form 20-16 Summary Sheet Form 20-16A Assurances-Nonconstruction Programs Form 20-16B Assurances-Construction Programs Form 20-16C Certifications Regarding Lobbying Standard Form LLL Disclosure of Lobbying Activities	.xls
Disclosure of Lobbying Activities	.pdf
FEMA 90-91 - Project Worksheet w/ Cost Summary Attachments (full functioning Excel version - requires macros)	.xls

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