Enclosure (4) to COMDTINST 16451.1
This form is the official obligating document for Taskings by FEMA to other Federal agencies.
RFA's may be initiated by a State request for assistance, FEMA, OFA, or other entity. This form is
used to record Taskings and obligations before and after Presidential declarations of a major
disasters or emergency.
Specific Instructions by Section
To be completed for all requests. Enter State or territory. If a disaster has been declared enter DR-
I. Assistance Requested
Assistance Reauested: Completed by requestor; should detail the what, where, when, how,
quantity, date/time needed, and specific deliverables.
Deliver to: Should be completed if items are for delivery. Attach any additional information.
Requestor/Phone #: The action officer for any further information for the request.
State Approving Official: Signs certifying that the request is valid and beyond the capability of
Sate and local government to provide.
Assigned Federal agency: Completed by FEMA for all requests whether initiated by the State or in
support of Federal operations.
Statement of Work: Developed by OFA, should detail the specific requirements to complete the
Project Completion Date: When work is expected to be complete.
Total Cost Estimate: Self explanatory.
OFA POC Name and Phone #: Action officer.
III. Coordination (FEMA Use Only)
Type: The MAC determines if the type of assistance is Direct Federal, Technical or Federal
State Cost Share %/$: The MAC records the Federal/State cost share percentage and dollar
Fund Citation: The MAC assigns the appropriate fund citation.
MAC (initial Federal Review): MAC signature.
Certifying Officer (funds availability): Finance Branch Liaison verifies funds availability.
State Approving Official: Signs for Direct Federal Assistance and Technical Assistance to State
and local governments.
Federal Approving Official: Signs ALL RFA's.
V. FEMA Use Only
MAC enters MA#, Amendment #, Amount for this Action, and Cumulative Amount and forwards
to the Finance Branch. Finance Branch records obligation, date, and initials.