OMB No: 1660-0072 | Expiration Date: 04-30-2026

Subpage to BRIC DTA Webpage: https://www.fema.gov/grants/mitigation/learn/building-resilient-infrastructure-communities/direct-technical-assistance

This form is for requesting non-financial Direct Technical Assistance (DTA) offered through the Building Resilient Infrastructure and Communities (BRIC) program provided by the Federal Emergency Management Agency (FEMA). Eligible communities request hazard mitigation assistance by completing this form. Each community or group of communities may only submit one request. This form closes Friday, April 18, 2025 at 3:00PM EST.

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COMMUNITY DETAILS AND CONTACT INFORMATION

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Are you a federally recognized Tribal Government(s)/entity?

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Are you a non-federally recognized Tribal Government(s)/entity?

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Does your community have or participate in a Hazard Mitigation Plan?

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Name the Hazard Mitigation Plan in which your community or communities participates.

ELIGIBILITY

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To be eligible for BRIC DTA, you must represent one or more of the options below. Please check all that apply.

HAZARD IDENTIFICATION

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Please check the box that describes the nature of the hazard(s) your community is facing. Please check all that apply.

BRIC DTA SUPPORT

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Through DTA, FEMA can provide support for hazard mitigation planning, mitigation project assistance, and Building Resilient
Infrastructure and Communities (BRIC) application-specific needs.

Please indicate a primary direct technical assistance need.

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If "Other" is selected, please explain further.

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Please briefly describe any disasters your community has experienced in the past seven years.

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Please provide a brief description of the community's need for BRIC DTA and any challenges you have faced.

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Please provide a brief description of proposed deliverables and timelines, including duration of technical assistance.

PREVIOUS FEMA ASSISTANCE

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Have you received a subaward (Project, Advance Assistance, Capability and Capacity Building) under BRIC, the Pre-Disaster Mitigation (PDM) grant program, the Flood Mitigation Assistance (FMA) grant program, or the Hazard Mitigation Grant Program (HMGP) within the past 5 years?

DISADVANTAGED COMMUNITIES

Social vulnerability refers to the potential negative effects on communities caused by external stresses include natural or human-caused disasters, or disease outbreaks. More information resources regarding the Social Vulnerability Index can be found here CDC/ATSDR Social Vulnerability Index (CDC/ATSDR SVI)

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Please briefly describe the social vulnerability within your community is potentially facing or has recently faced below.

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Is your community 3,000 or fewer individuals?

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Are you designated as a disadvantaged community as defined by Executive Order 14008, including Tribal Nation Government(s)?

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POINT OF CONTACT ACKNOWLEDGEMENT

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Attach any additional document as needed

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