{"text_format":"3","workbook":"xlsx","n_sheets":2,"sheets":["RPA","PNP Questionaire"],"not_rendered":{"defined_names":14},"read":"whole","date_system":"1900"}

{"sheet":"RPA","index":0,"n_rows":44,"n_cols":7,"rows_kept":44,"merged":[[0,1,0,6],[1,1,1,6],[2,1,2,6],[3,1,3,6],[4,1,4,5],[5,1,5,5],[6,1,6,6],[7,1,7,6],[8,1,8,6],[9,1,9,6],[10,1,10,6],[11,1,11,2],[11,3,11,4],[12,1,12,2],[12,3,12,4],[13,1,13,6],[14,1,14,6],[15,1,15,6],[16,2,16,4],[17,2,17,4],[18,1,18,3],[18,4,18,6],[19,1,19,3],[19,4,19,6],[20,1,20,3],[20,4,20,6],[21,1,21,3],[21,4,21,6],[22,1,22,3],[22,4,22,6],[23,1,23,3],[23,4,23,6],[24,1,24,3],[24,4,24,6],[25,1,25,3],[25,4,25,6],[26,1,26,3],[26,4,26,6],[27,1,27,3],[27,4,27,6],[28,1,28,3],[28,4,28,6],[29,1,29,3],[29,4,29,6],[30,1,30,3],[30,4,30,6],[31,1,31,3],[31,4,31,6],[32,1,32,3],[32,4,32,6],[33,1,33,3],[33,4,33,6],[34,1,34,3],[34,4,34,6],[35,1,35,5],[36,1,36,5],[37,1,37,3],[37,4,37,6],[38,1,38,6],[39,1,40,6],[41,1,41,2],[41,5,41,6],[42,1,42,4],[42,5,42,6],[43,1,43,2]]}
[]
[null,"Division of Homeland Security and Emergency Management"]
[null,"REQUEST FOR PUBLIC ASSISTANCE"]
[null,"Submittal of the Request for Public Assistance Form is the initial step in filing for disaster assistance. After a disaster declaration, state and local government agencies, Native American Tribal organizations and eligible private nonprofit Organizations interested in filing must complete and submit this form to DHS&EM. The submittal deadline for this form is no later than 30 days after your area is designated eligible for Public Assistance."]
[null," APPLICANT (Political subdivision or PNP) Must match name registered for Tax ID",{"$nulls":4}," DATE SUBMITTED"]
[]
[null," Borough, or Regional Education Attendance Area (REAA)"]
[]
[null,"APPLICANT PHYSICAL LOCATION"]
[null," STREET ADDRESS"]
[]
[null," CITY",null," COUNTY",null," STATE"," ZIP CODE"]
[]
[null,"MAILING ADDRESS (If different from Physical Location)"]
[null," STREET ADDRESS"]
[]
[null," POST OFFICE BOX"," CITY",null,null," STATE"," ZIP CODE"]
[]
[null,"Primary Contact/Applicant’s Authorized Agent",null,null,"Alternate Contact"]
[null," NAME",null,null," NAME"]
[]
[null," TITLE",null,null," TITLE"]
[]
[null," BUSINESS PHONE",null,null," BUSINESS PHONE"]
[]
[null," FAX NUMBER",null,null," FAX NUMBER"]
[]
[null," HOME PHONE (Optional)",null,null," HOME PHONE (Optional)"]
[]
[null," CELL PHONE",null,null," CELL PHONE"]
[]
[null," E-MAIL ADDRESS",null,null," E-MAIL ADDRESS"]
[]
[null," PAGER & PIN NUMBER",null,null," PAGER & PIN NUMBER"]
[]
[null," Did you participate in the Federal/State Preliminary Damage Assessment (PDA)?"]
[null," Private Non-Profit Organization?"]
[null," If yes, which of the facilities identified below best describe your organization?"]
[null,"An eligible private non-profit facility is defined as: “…any private non-profit educational, utility, emergency, medical or custodial care facility, including a facility for the aged or disabled and other facility providing essential governmental type services to the general public, and such facilities on Indian reservations.” Other essential governmental service facility means museums, zoos, community centers, libraries, homeless shelters, senior citizen centers, rehabilitation facilities, shelter workshops and facilities which provide health and safety services of a governmental nature. All facilities must be open to the general public."]
[null," Private Non-Profit Organizations must attach copies of their Tax Exemption Certificate and Organization Charter or By-Laws.  If your organization is a school or educational facility, please attach information or accreditation or certification."]
[]
[null,"DUNS:",null,"Tax ID: ",null," Date Received:"]
[null,"Principal Executive Officer Signature:\n\n\n",{"$nulls":3},"Date of Signature:\n\n\n"]
[null,"DHS&EM Form 30-1, Feburary 2019",null,"REPLACES ALL PREVIOUS EDITIONS."]

{"sheet":"PNP Questionaire","index":1,"n_rows":40,"n_cols":7,"rows_kept":40,"merged":[[0,1,0,6],[1,1,1,5],[2,1,2,5],[3,1,3,5],[4,1,4,6],[5,1,5,6],[6,1,6,6],[7,2,7,6],[8,1,8,2],[8,3,8,6],[9,1,9,6],[10,4,10,6],[12,1,12,3],[14,2,14,6],[16,1,16,3],[16,4,16,6],[18,1,18,3],[20,1,20,4],[22,4,22,6],[36,1,36,6],[38,1,38,4],[38,5,38,6]]}
[null,"ONLY need to fill out the yellow boxes."]
[]
[null,"Division Of Homeland Security and Emergency Management",{"$nulls":4},"O.M.B. NO. 1660-0017"]
[null,"PNP FACILITY QUESTIONNAIRE"]
[null,"PAPERWORK BURDEN DISCLOSURE NOTICE"]
[null,"Public reporting burden for this form is estimated to average 30 minutes per response.  The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing, reviewing, and submitting the form.  You are not required to respond to this collection of information however, submission of the form is required to obtain benefits under the Public Assistance Program.  "]
[null,"State personnel will use this questionnaire to determine the eligibility of specific facilities of an approved Private Non-Profit (PNP) organization (See State Administrative Plan).  Owners of critical facilities (i.e., power, water, (including provided by an irrigation organization or facility, if it is not provided solely for irrigation purposes), sewer, wastewater treatment, communications and emergency medical care) can apply directly to the State for assistance for emergency work (debris removal and emergency protective measures) and permanent work (repair, restore or replace a damaged facility).  Owners of non-critical facilities can apply directly to the State for assistance for emergency work, but must first apply to the U.S. Small Business Administration (SBA) for assistance for permanent work.  If the owner of a non-critical facility does not qualify for an SBA loan or the cost to repair the damage facility exceeds the SBA loan amount, the owner may apply directly to the State for permanent work."]
[null,"  1.  Name of PNP Organization:"]
[null,"  2.  Name of damaged facility and location:"]
[]
[null,"  3.  What is the primary purpose of the damaged facility?"]
[]
[null,"  4.  Is the facility a critical facility as defined above?"]
[]
[null,"  5.  Who may use the facility?"]
[]
[null,"  6.  What fee, if any, is charged for the use of the facility?"]
[]
[null,"  7.  Was the facility in use at the time of the disaster?"]
[]
[null,"  8.  Did the facility sustain damage as a direct result of the disaster?"]
[]
[null,"  9.  What type of assistance is being requested?"]
[]
[null,"  10.  Does the PNP organization own the facility?"]
[]
[null,"  11.  If \"Yes,\" obtain proof of ownership; check here if attached."]
[]
[null,"  12.  Does the PNP organization have legal responsibility to repair the facility?"]
[]
[null,"  13.  If \"Yes,\" provide proof of legal responsibility; check here if attached."]
[]
[null,"  14.  Is the facility insured?"]
[]
[null,"  15.  If \"Yes,\" obtain a copy of the insurance policy; check here if attached."]
[null,"  Additional information or comments:"]
[]
[null,"  CONTACT PERSON",{"$nulls":3},"TELEPHONE NO."]
[]
[null,"DHS&EM Form 30-1a",null,null,"PREVIOUS EDITION OBSOLETE"]